Migraines & Headaches Health Center

Status Migrainosus

Migraines are a type of headache that tend to cause more than just head pain. The symptoms 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.

A typical migraine can sometimes turn into status migrainosus if:

• The migraine isn't treated early and treatment is delayed.
• The migraine is treated with headache medicine that's not specifically intended for migraines.
• 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 and loss of vision (aura)
• Vomiting
• Difficulty thinking properly

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

• Dehydration
• Fatigue due to sleep loss

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 to treat dehydration.

Drugs used to end vomiting include:

• metoclopramide (Maxolon, Metozolv, Reglan)
• chlorpromazine (Thorazine)
• prochlorperazine (Compazine)

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:

• Beta-blockers. These drugs, which are also used for reducing blood pressure, are a common preventive treatment for people with frequent migraines. They include atenolol (Senormin, Tenormin), metoprolol (Lopressor, Toprol), nadolol (Corgard), and propranolol (Inderal, InnoPran, Pronol).
• Calcium channel blockers, which are also used for high blood pressure.
• Types of antidepressants known as tricyclics and monoamine oxidase inhibitors.
• Anti-seizure medicines such as divalproex sodium and sodium valproate.
• Botox. Though better known as a treatment for wrinkles, Botox has been approved by the FDA to prevent chronic migraines.
• Natural therapies such as magnesium.