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Status Migrainosus

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Updated April 29, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Symptoms of Status Migrainosus

The symptoms of status migrainosus are similar to whatever your "typical" migraine symptoms may be. The main difference is that in status migraines the symptoms are continuous for more than 72 hours. There may be periods of relative relief, but these are generally shorter than about 4 hours. Symptoms the International Headache Society include in the description of migraines include:

  • Unilateral location (one side)
  • Throbbing character
  • Worsening pain with normal activity
  • Moderate to severe intensity
In addition, patients must have at least one of the following:

Treating Status Migrainosus

Nearly all patients with status migrainosus will tell you their regular migraine treatments are not helping. Besides trying to "break" the headache, treatment of status migrainosus includes managing all of the "extra" problems like nausea and vomiting or dehydration. Many times status migraines are treated in the emergency room and the usual treatment includes intravenous (IV) fluids and medications to control nausea and vomiting, like Reglan (metoclopramide).

Medications used to abort a status migraine may include one of the triptans or DHE. Historically steroids like dexamethasone or hydrocortisone have been used in some occasions

What To Do

As with all headaches, try to notice if you are having new symptoms or symptoms that are more severe than usual. Be sure to be familiar with headache warning signs, or reasons for alarm. Also be sure to notify your health care provider if you have a migraine that lasts long enough to be considered a status migraine.

Sources

Morley, Sharon Scott. "Guidelines on Migraine: Part 3. Recommendations for Individual Drugs.” Am Fam Phys. 2000; 62:2145-52.

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