Migraines are a type of headache that tend to cause other symptoms, too, such as nausea and vision problems. They can last for a few hours to a few days. But a migraine that lasts for more than 72 hours is called status migrainosus. To treat it, you may need to go to the hospital to get help relieving the pain and dehydration from vomiting.
A typical migraine can sometimes turn into status migrainosus if:
- You don’t get treatment early enough after the attack starts.
- You don’t get the right treatment.
- You use too much headache medicine.
The warning signs of status migrainosus are similar to those of a typical migraine. Along with pain in your head, you might also feel:
- Sensation of sparkling lights or other vision changes (aura)
- Nausea and vomiting
- Trouble thinking clearly
Because the condition lasts for at least 3 days, you’re also at risk for dehydration and sleep loss because of prolonged vomiting and pain.
If you have to go to an emergency room or stay in the hospital because of status migrainosus, doctors may need to treat other problems the migraine causes as well as the migraine itself.
In the hospital, doctors may give you drugs through an IV to control pain. They'll treat dehydration by giving you fluids through an IV.
Drugs that stop vomiting include:
A common medicine for halting status migrainosus is dihydroergotamine (DHE-45, Migranal). You can take it as a nasal spray or through a shot. Another drug, sumatriptan (Alsuma, Imitrex, Onzetra, Sumavel DosePro, Zecuity), comes as a shot, nasal spray, pill, or skin patch.
People with blood vessel problems should avoid these drugs, though.
If you get migraines often, you may want to take medicines to prevent them. The drugs may not completely keep your headaches away, but they may help you have fewer attacks that can turn into status migrainosus.
These medications include:
- Drugs that lower blood pressure, called beta-blockers. They include atenolol (Tenormin), metoprolol (Lopressor,Toprol), nadolol (Corgard), and propranolol (Hemangeol, Inderal, InnoPran).
- Another type of drug for high blood pressure, called calcium channel blockers.
- Types of antidepressants known as tricyclics (such as amitriptyline) and SNRIs (such as venlafaxine).
- Anti-seizure medicines such as valproate and topiramate.
- Botox. Though better known as a treatment for wrinkles, the FDA also approved it to prevent recurring migraines.
- Natural options such as magnesium. But we need more research to know which of these treatments are effective.