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Migraine diagnosis and management in general emergency departments in France

Background: We conducted a prospective study of patients admitted to 22 general emergency departments in France over 1 week. Patients and methods: Of 15,835 adult patients, 483 (3.1%) had headache and 98 (0.6%) had migraine. Results: Compared with the migraine population in France, our migraine patients were similar in terms of proportion of female patients (75%) and mean age (37.6 ± 13.8 years) but presented earlier in their disease course. Patients sought emergency treatment because of a severe attack (49%) or because of ineffective treatment (20%). Non-opioid analgesics excluding non-steroidal anti-inflammatory drugs (NSAIDs), and NSAIDs, were most commonly prescribed as acute treatment, yet it took more than 48 h for symptom resolution in 36% of 92 follow-up patients. Conclusions: Results suggest there is room for improvement in choice of agents prescribed. We propose additional education and training of clinicians to improve adherence to clinical practice guidelines.