For some patients who come to the emergency department for treatment of a migraine headache, peripheral headache nerve blocks (PHNB) have proven to be an efficient and effective treatment for headache relief. Previous studies have demonstrated that adding steroids as an adjunct treatment to standard migraine treatment can reduce recurrence of headaches in the subsequent few days.
Meet ICHD-3 Migraine Headache Criteria
Had a minimum 5-point reduction in headache intensity after nerve block(s) or post- block pain score of 0 to 2
Nerve block performed with bupivacaine 0.5%
Head trauma
Suspicion of secondary headache (i.e. stroke, known tumor, glaucoma)
Headache in the setting of viral syndrome
Chronically on steroids
Parallel
Dexamethasone Oral
DrugTwo 4mg pills
Placebo
Drug2 placebo pills
Recurrence of headache
Subjects will be contacted 72 hrs post treatment to determine if migraine headache has recurred
Early recurrence headache and timing
HA severity, location, time since enrollment enrollment,medications
side effects of dexamethasone identified if any
elevation in glucose level, other symptoms associated with corticosteroids
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