Is ineffective acute treatment of episodic migraine associated with new-onset chronic migraine?
Inadequate acute treatment efficacy was associated with an increased risk of new-onset CM over the course of 1 year. Improving acute treatment outcomes might prevent new-onset CM, although reverse causality cannot be excluded.
In our population, the reputation of inefficacy and morbidity of local corticosteroid therapy appears to be unjustified. There were no cases of deterioration, but, on the contrary, stabilization and especially very marked and rapid efficacy on pain, but a lesser efficacy on curvature and plaque. Local steroid therapy appears justified during the acute phase, as the injection allows corticosteroids to exert their anti-inflammatory action in situ in line with the pathophysiology of the disease. A standardized, multicentre, prospective, randomized, placebo-controlled study could confirm our impressions.