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Children and teenagers with prolonged severe migraines can be treated at St. Joseph Mercy Ann Arbor (SJMAA) when other treatments are not working. If a pediatric patient has had a headache for more than 3 days that is bad enough to get in the way of his/her usual activities (such as attending school) and outpatient treatments are not working, the patient may qualify for the SJMAA inpatient "DHE treatment protocol." DHE is a medication used to treat headaches that works by causing the blood vessels to constrict and therefore slightly reducing the blood flow through them. SJMAA is one of the few centers in the country offering this service for children and teens and the only one in southeastern Michigan.

Patients admitted for the DHE protocol are admitted to the pediatric unit at SJMAA under the care of the pediatric hospitalist team. Dr. Brian Woodruff, pediatric neurologist, also consults on these patients. Patients receive DHE through an IV every 6 hours for up to 8 doses or until the headache is gone, whichever is less. After the headache ends, one more dose of DHE is given to maximize the effectiveness of the treatment. The average hospital stay is about 36 hours and the maximum is around 52 hours. 86% of patients treated with this protocol have their headache go away completely. Most of the others have great improvement. In addition to the medication, patients are kept in a quiet, dark environment that promotes rest and as much sleep as possible. Visitors and other stimuli, such as television and phone use, are restricted to improve the effectiveness of this treatment. Consultation with the hospital social worker is available for those who need support in areas such as coping with chronic pain, family stress related to illness, and the issues of returning to school after a long absence.

For more information about how to be evaluated for possible inpatient treatment with DHE, contact Dr. Brian Woodruff, IHA pediatric neurologist, at 734-930-5300, or Dr. Anne Vanden Belt, Associate Chair of Pediatrics at SJMAA, at 734-712-3325.