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Status Migrainosus

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Migraines are a type of headache that tend to cause more than just head pain. The symptoms often include nausea and vision problems.

A migraine headache can last for a few hours a day to several hours. But a migraine attack that lasts for more than 72 hours is called status migrainosus. This may require hospital treatment to relieve the pain and treat dehydration from vomiting.

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A typical migraine can sometimes turn into status migrainosus if:

  • The migraine isn't treated early in the course of the attack.
  • The migraine isn't treated correctly.
  • Headache medication is overused.

Symptoms of Status Migrainosus

The symptoms of status migrainosus are similar to symptoms of a typical migraine. Along with pain in the head, common symptoms include:

  • Sensation of sparkling lights or other vision changes (aura)
  • Nausea and vomiting
  • Difficulty thinking properly

Because status migrainosus lasts for at least three days, prolonged vomiting and pain can lead to:

Treatment for Status Migrainosus

If you have to go to an emergency room or you are admitted to the hospital because of status migrainosus, doctors may need to treat the complications of the migraine as well as the migraine itself.

In the hospital, doctors may administer drugs through an IV to control pain. They will treat dehydration by administering fluids through an IV.

Drugs used to end vomiting include:

A commonly used medicine for halting status migrainosus is dihydroergotamine (DHE-45, Migranal). This is a migraine treatment that dates back to the 1940s. The drug may be taken as a nasal spray or through an injection.

Another drug that can halt status migrainosus is sumatriptan. It is given as an injection, nasal spray, pill, or skin patch.

However, people with blood vessel disease should avoid these drugs.

The corticosteroids dexamethasone (Decadron, Dexamethasone Intensol, Dexpak) and prednisolone can also relieve status migrainosus.

Preventing Migraines

If you have frequent migraines you may want to take medicines to prevent them. These may not completely prevent migraines. But they may reduce the number or severity of attacks that can turn into status migrainosus.

These medications include:

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on November 21, 2014
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