Intravenous Fluids in Benign Headaches Trail
Intravenous Fluids in Benign Headaches Trail
Migraine headache has a 1-year period prevalence in the US of 11.7% and accounts for
 approximately 1.2 million migraine visits to US emergency departments per year . There are
 numerous studies that discuss treatment for migraine and other benign headaches within the
 emergency department (ED), however, there are very few that discuss specifically the use of
 intravenous fluids (IVF) for headache treatment. Many of these studies look at various
 options for treating migraine and other benign headaches: treatment options include dopamine
 antagonists, opioids, non-steroid anti-inflammatory drugs (NSAIDs), triptans, anti-epileptics
 and ergot derivatives. Comparisons have been done between many of these treatment options
 with dopamine antagonists appearing to be the most effective, compared to other treatments
 The dopamine antagonist with the most evidence and availability for benign headaches is
 prochlorperazine. Given that IVF administration is a common part of treatment regimen for
 benign headache patients in the emergency department and given the lack of randomized trials
 in adults, the investigators aim to study the use of IVF on pain reduction in headache
 patients in the adult ED. There has been one randomized trial in pediatrics that shows IVF
 may help in patients with migraines, whereas the adult literature has no randomized control
 trials and a review of data shows that fluids do not help relieve pain in migraine headache
 patients. This study will include both adult and pediatric patients presenting to the
 Emergency Department with complaint of benign headache.
This will be a single center, prospective, single blinded randomized controlled trial on a
 convenience sample of patients presenting to the adult or pediatric ED with a chief complaint
 of headache. Subjects will only be enrolled when a physician or research assistant who is
 familiar with the study protocol is available to enroll patients. Written, informed consent
 will be obtained from each patient. Consent will include a discussion of the risks and
 benefits. In addition to parental informed consent in the pediatric population, age
 appropriate verbal assent will be obtained from pediatric subjects. After 30 minutes, the
 treating provider will be permitted to administer a "rescue medication" of their choice for
 further treatment. If there is an untoward event that requires the patient to know which IVF
 dose was administered, patient will unblinded and will not continue in the study.
Inclusion Criteria:

 1. Age 10 to 65 years

 2. Temperature less than 100.4 F

 3. Normal neurologic exam and normal mental status

 Exclusion Criteria:

 1. Pregnant

 2. Meningeal signs are present

 3. Acute angle closure glaucoma is suspected

 4. Head trauma within the previous two weeks

 5. Lumbar puncture within the previous two weeks

 6. Thunderclap onset of the headache

 7. Known allergy to one of the study drugs

 8. History of intracranial hypertension

 9. Is a prisoner

 10. Patient declined informed consent

 11. Non-English speaking patient or parent/guardian for pediatric patients

 12. Attending provider excludes patient

 13. Severe Dehydration