Assessment of Therapeutic Effects of Subcutaneous...

Background and Objective: Neurologic literatrure about therapeutic effect of subcutaneous corticosteroids in patients with migrainous chronic daily headache is scare. Aim of this research is assessment of therapeutic effects of this management in the patients. Methods: Consecutive patients with migrainous chronic daily headache in our headache clinic enrolled a prospective before and after therapeutic study during 2010-2013. Fourty mg Metylprednisolone was divided in four subcutaneous injection doses. Two injections were done in right and left suboccipital area exactly at retromastoid cervicocranial junction and two injections were performed in lower medial frontal area exactly at medial right and left eye brow limit. A headache daily was filled out by the patient before and one month after intervention. The severity of pain was classified based on the Pain Intensity Instrument, using a 0-to-10 point numeric rating scale. Paired t test and Chi-square served for statistical analysis. Results: 504 patients (378 females, 126 males) with migrainous chronic daily headache underwent the study. Dramatic, significant, moderate and mild or no improvement constituted 28.6%, 33.3%, 23.8%, and 14.3% of the post treatment courses respectively. Therapeutic effect of intervention on mean pain scores was significant; t=7.38, df=20, p=.000. Two cases developed subcutaneous fat atrophy in frontal injection site and 3 cases experienced syncope during injection. Conclusion: Subcutaneous