TRATAMENTO DA MIGRANEA REFRATÁRIA NA EMERGÊNCIA

Abstract One of the primary neurological complaints in emergency care units is headaches, predominantly affecting young women of childbearing age. Among headache subtypes, migraines are highly disabling, significantly impacting quality of life and imposing a substantial burden on healthcare systems. When preventive and acute migraine treatments fail, the condition is classified as refractory, requiring more aggressive approaches. This study aimed to evaluate the therapeutic response to treatment of refractory migraine in the Emergency Unit of the Barbacena Hospital Complex. It was a prospective observational study involving patients classified as refractory, here defined by failure to respond to at least three adequately dosed medications. After obtaining consent, demographic and medical history data were collected, and patients completed the Visual Analog Scale (VAS) to quantify pain. The treatment protocol included 5 mg of haloperidol (oral or intravenous) and 4 mg of dexamethasone (oral or intravenous). Pain intensity was reassessed and quantified two hours post-administration. The study was conducted from August 1, 2023, to July 31, 2024, with 16 participants: 15 females and 1 male, with a mean age of 32 years. The results were favorable, with a reduction of at least 2 points on the pain scale in all patients. This suggests that the combination of haloperidol and dexamethasone is a promising option for treating patients unresponsive to conventional therapies, providing significant pain relief.