Twelve children with migraine symptoms that did not respond to convent
ional analgesics completed a double-blind, placebo-controlled, cross-o
ver study of two doses of oral dihydroergotamine (DHE) for acute treat
ment. The primary endpoint was reduction of headache by greater than o
r equal to 2 grades on a 5-grade scale at 2 hours. After DHE, 7 of the
12 children reached the primary endpoint, and 2 reached the primary e
ndpoint after placebo [difference 42%; 95% confidence interval (CI) 14
%-70%]. Five of the 7 were pain-free after DHE (3 with 20 mu g/kg; 2 w
ith 40 mu g/kg); none was pain-free after placebo. Headache recurred i
n 2 of the 5. Although headache recurrence limits the efficacy of oral
DHE, it may be useful in the acute treatment of migraine in selected
children. (C) 1997 by Elsevier Science Inc.