Intravenous Magnesium As Acute Treatment for Headaches: A Pediatric Case Series

Abstract Background Acute i.v. treatment for pediatric headache varies widely. Objectives Our aim was to describe our experience with i.v. magnesium for acute treatment of pediatric headache. Methods We reviewed the electronic medical records of all patients ages 5 to 18 years old treated with a sta...

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Veröffentlicht in:The Journal of emergency medicine 2014-02, Vol.46 (2), p.308-312
Hauptverfasser: Gertsch, Emily, MD, MPH, Loharuka, Sheila, BS, Wolter-Warmerdam, Kristine, MA, Tong, Suhong, MS, Kempe, Allison, MD, MPH, Kedia, Sita, MD
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container_end_page 312
container_issue 2
container_start_page 308
container_title The Journal of emergency medicine
container_volume 46
creator Gertsch, Emily, MD, MPH
Loharuka, Sheila, BS
Wolter-Warmerdam, Kristine, MA
Tong, Suhong, MS
Kempe, Allison, MD, MPH
Kedia, Sita, MD
description Abstract Background Acute i.v. treatment for pediatric headache varies widely. Objectives Our aim was to describe our experience with i.v. magnesium for acute treatment of pediatric headache. Methods We reviewed the electronic medical records of all patients ages 5 to 18 years old treated with a standard dose of i.v. magnesium for headache at our institution from January 2008 to July 2010. Charts were assessed for headache diagnosis, prior medications given, side effects, tolerability, and response to treatment. Individuals were excluded if they had an underlying unstable medical condition or a secondary etiology for headache. Only first encounters were included if the patient had multiple encounters. Results There were 34 episodes of children who received i.v. magnesium in the emergency department (ED) or hospital. Of these, 14 were excluded because the patients had complex medical conditions (n = 6), they were repeat encounters (n = 7), or known secondary etiology for the headache (n = 1). Of the 20 included charts (range 13–18 years old), 5 had migraine, 4 had tension-type headache, and 11 had status migrainosus. Thirteen were treated in the ED and seven as an inpatient with a standard i.v. dose of magnesium. Ten of thirteen adolescents receiving i.v. magnesium in the ED were admitted for further headache treatment but not for side effects, and three were discharged home. Side effects of treatment included pain (1 of 20), redness (1 of 20), burning (1 of 20), and decreased respiratory rate without change in oxygenation (1 of 20). Conclusions In our case series, adolescents given i.v. magnesium as an abortive therapy for headache experienced minimal side effects and further studies should evaluate for effectiveness.
doi_str_mv 10.1016/j.jemermed.2013.08.049
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Objectives Our aim was to describe our experience with i.v. magnesium for acute treatment of pediatric headache. Methods We reviewed the electronic medical records of all patients ages 5 to 18 years old treated with a standard dose of i.v. magnesium for headache at our institution from January 2008 to July 2010. Charts were assessed for headache diagnosis, prior medications given, side effects, tolerability, and response to treatment. Individuals were excluded if they had an underlying unstable medical condition or a secondary etiology for headache. Only first encounters were included if the patient had multiple encounters. Results There were 34 episodes of children who received i.v. magnesium in the emergency department (ED) or hospital. Of these, 14 were excluded because the patients had complex medical conditions (n = 6), they were repeat encounters (n = 7), or known secondary etiology for the headache (n = 1). Of the 20 included charts (range 13–18 years old), 5 had migraine, 4 had tension-type headache, and 11 had status migrainosus. Thirteen were treated in the ED and seven as an inpatient with a standard i.v. dose of magnesium. Ten of thirteen adolescents receiving i.v. magnesium in the ED were admitted for further headache treatment but not for side effects, and three were discharged home. Side effects of treatment included pain (1 of 20), redness (1 of 20), burning (1 of 20), and decreased respiratory rate without change in oxygenation (1 of 20). Conclusions In our case series, adolescents given i.v. magnesium as an abortive therapy for headache experienced minimal side effects and further studies should evaluate for effectiveness.</description><identifier>ISSN: 0736-4679</identifier><identifier>EISSN: 2352-5029</identifier><identifier>DOI: 10.1016/j.jemermed.2013.08.049</identifier><identifier>PMID: 24182946</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; alternative therapy ; Analgesics, Non-Narcotic - administration &amp; dosage ; CAM ; Emergency ; Emergency Service, Hospital ; Female ; headache ; Headache - drug therapy ; Humans ; Injections, Intravenous ; Magnesium - administration &amp; dosage ; Male ; migraine ; Migraine Disorders - drug therapy ; pain ; pediatric ; Retrospective Studies</subject><ispartof>The Journal of emergency medicine, 2014-02, Vol.46 (2), p.308-312</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. 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Objectives Our aim was to describe our experience with i.v. magnesium for acute treatment of pediatric headache. Methods We reviewed the electronic medical records of all patients ages 5 to 18 years old treated with a standard dose of i.v. magnesium for headache at our institution from January 2008 to July 2010. Charts were assessed for headache diagnosis, prior medications given, side effects, tolerability, and response to treatment. Individuals were excluded if they had an underlying unstable medical condition or a secondary etiology for headache. Only first encounters were included if the patient had multiple encounters. Results There were 34 episodes of children who received i.v. magnesium in the emergency department (ED) or hospital. Of these, 14 were excluded because the patients had complex medical conditions (n = 6), they were repeat encounters (n = 7), or known secondary etiology for the headache (n = 1). Of the 20 included charts (range 13–18 years old), 5 had migraine, 4 had tension-type headache, and 11 had status migrainosus. Thirteen were treated in the ED and seven as an inpatient with a standard i.v. dose of magnesium. Ten of thirteen adolescents receiving i.v. magnesium in the ED were admitted for further headache treatment but not for side effects, and three were discharged home. Side effects of treatment included pain (1 of 20), redness (1 of 20), burning (1 of 20), and decreased respiratory rate without change in oxygenation (1 of 20). Conclusions In our case series, adolescents given i.v. magnesium as an abortive therapy for headache experienced minimal side effects and further studies should evaluate for effectiveness.</description><subject>Adolescent</subject><subject>alternative therapy</subject><subject>Analgesics, Non-Narcotic - administration &amp; dosage</subject><subject>CAM</subject><subject>Emergency</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>headache</subject><subject>Headache - drug therapy</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>Magnesium - administration &amp; dosage</subject><subject>Male</subject><subject>migraine</subject><subject>Migraine Disorders - drug therapy</subject><subject>pain</subject><subject>pediatric</subject><subject>Retrospective Studies</subject><issn>0736-4679</issn><issn>2352-5029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQxi0EokvhFaocuSR47CS2OVSsVkArFVGp5TzyOrOtQ_4UO1mpb8Oz8GQ42rYCLpzm4G9-M_6-YewEeAEc6ndt0VJPoaemEBxkwXXBS_OMrYSsRF5xYZ6zFVeyzstamSP2KsaWc1Bcw0t2JErQwpT1il2eD1OwexrGOWZf7M1A0c99to7Z2s0TZdeB7NTTMGW7MWRnZBvrbim-z9a_fl5S4-0UvMs2NlJ2RcFTfM1e7GwX6c1DPWbfPn283pzlF18_n2_WF7mrRD3lpXGm1KIC0gZUSdxtt2arbCOcaqpqZ4SVpIHrGozVVhhuQatKSF1xaVUjj9npgXs3b5MLjpZ_dHgXfG_DPY7W498vg7_Fm3GP0lQAIBLg7QMgjD9mihP2PjrqOjtQMgOhNKLWiguVpPVB6sIYY6Dd0xjguMSBLT7GgUscyDWmOFLjyZ9LPrU9-p8EHw4CSlbtPQWMztPgkrOB3ITN6P8_4_QfhOv84J3tvtM9xXacw5CCQMAokOPVchTLTYDkCWtq-Rs94rSt</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Gertsch, Emily, MD, MPH</creator><creator>Loharuka, Sheila, BS</creator><creator>Wolter-Warmerdam, Kristine, MA</creator><creator>Tong, Suhong, MS</creator><creator>Kempe, Allison, MD, MPH</creator><creator>Kedia, Sita, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140201</creationdate><title>Intravenous Magnesium As Acute Treatment for Headaches: A Pediatric Case Series</title><author>Gertsch, Emily, MD, MPH ; Loharuka, Sheila, BS ; Wolter-Warmerdam, Kristine, MA ; Tong, Suhong, MS ; Kempe, Allison, MD, MPH ; Kedia, Sita, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-49c948251e89174e0cbb9b7ad2c7d55f92a3e8108619a8a290a1875238503a7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>alternative therapy</topic><topic>Analgesics, Non-Narcotic - administration &amp; dosage</topic><topic>CAM</topic><topic>Emergency</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>headache</topic><topic>Headache - drug therapy</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>Magnesium - administration &amp; dosage</topic><topic>Male</topic><topic>migraine</topic><topic>Migraine Disorders - drug therapy</topic><topic>pain</topic><topic>pediatric</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gertsch, Emily, MD, MPH</creatorcontrib><creatorcontrib>Loharuka, Sheila, BS</creatorcontrib><creatorcontrib>Wolter-Warmerdam, Kristine, MA</creatorcontrib><creatorcontrib>Tong, Suhong, MS</creatorcontrib><creatorcontrib>Kempe, Allison, MD, MPH</creatorcontrib><creatorcontrib>Kedia, Sita, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gertsch, Emily, MD, MPH</au><au>Loharuka, Sheila, BS</au><au>Wolter-Warmerdam, Kristine, MA</au><au>Tong, Suhong, MS</au><au>Kempe, Allison, MD, MPH</au><au>Kedia, Sita, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous Magnesium As Acute Treatment for Headaches: A Pediatric Case Series</atitle><jtitle>The Journal of emergency medicine</jtitle><addtitle>J Emerg Med</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>46</volume><issue>2</issue><spage>308</spage><epage>312</epage><pages>308-312</pages><issn>0736-4679</issn><eissn>2352-5029</eissn><abstract>Abstract Background Acute i.v. treatment for pediatric headache varies widely. Objectives Our aim was to describe our experience with i.v. magnesium for acute treatment of pediatric headache. Methods We reviewed the electronic medical records of all patients ages 5 to 18 years old treated with a standard dose of i.v. magnesium for headache at our institution from January 2008 to July 2010. Charts were assessed for headache diagnosis, prior medications given, side effects, tolerability, and response to treatment. Individuals were excluded if they had an underlying unstable medical condition or a secondary etiology for headache. Only first encounters were included if the patient had multiple encounters. Results There were 34 episodes of children who received i.v. magnesium in the emergency department (ED) or hospital. Of these, 14 were excluded because the patients had complex medical conditions (n = 6), they were repeat encounters (n = 7), or known secondary etiology for the headache (n = 1). Of the 20 included charts (range 13–18 years old), 5 had migraine, 4 had tension-type headache, and 11 had status migrainosus. Thirteen were treated in the ED and seven as an inpatient with a standard i.v. dose of magnesium. Ten of thirteen adolescents receiving i.v. magnesium in the ED were admitted for further headache treatment but not for side effects, and three were discharged home. Side effects of treatment included pain (1 of 20), redness (1 of 20), burning (1 of 20), and decreased respiratory rate without change in oxygenation (1 of 20). Conclusions In our case series, adolescents given i.v. magnesium as an abortive therapy for headache experienced minimal side effects and further studies should evaluate for effectiveness.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24182946</pmid><doi>10.1016/j.jemermed.2013.08.049</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
alternative therapy
Analgesics, Non-Narcotic - administration & dosage
CAM
Emergency
Emergency Service, Hospital
Female
headache
Headache - drug therapy
Humans
Injections, Intravenous
Magnesium - administration & dosage
Male
migraine
Migraine Disorders - drug therapy
pain
pediatric
Retrospective Studies
title Intravenous Magnesium As Acute Treatment for Headaches: A Pediatric Case Series
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