Status migrainosus is a type of migraine that is difficult to treat. It’s a migraine that lasts more than 72 hours.
Treatments for migraines may not be effective in treating status migrainosus. However, there are a number of options for dealing with it.
The episodes can become debilitating and interfere with daily life. A person may require hospital treatment to break the cycle of symptoms.
In this article, we’ll look at what causes status migrainosus, how it differs from other types of migraine, and how to alleviate symptoms.
What is it?
A severe migraine attack that lasts more than 72 hours is known as status migrainosus. The same symptoms that characterize a person’s usual migraine attacks may be present, but they may be more severe.
The main sign of status migrainosus is the persistent headache and accompanying symptoms. When traditional methods of symptom management, such as rest and medication, fail, hospitalization may be required.
The majority of migraine attacks follow a distinct pattern. A warning period may precede this, which may include visual problems or other sorts of aura.
Following that, during the attack phase of a migraine episode, a person may have a headache and:
- sensitivity to light and noise
- fatigue
- nausea and possibly vomiting
The person may feel a migraine “hangover” as these symptoms fade, which can last hours or even days.
A person can distinguish a migraine episode from other forms of headaches based on the sequence of symptoms.
The headache phase of status migrainosus lasts for at least 72 hours, or three days.
Symptoms
The pain and nausea of status migrainosus are so intense for some people that they must spend time in a hospital.
The symptoms are comparable to those of other migraine types, but they linger longer and are more severe.
Migraine symptoms can also differ from person to person and episode to episode, although they typically look like this:
Phase of the prodrome
Mood swings, food cravings, nausea, difficulty sleeping, concentration, sensitivity to light and sound, and other symptoms may occur. They can persist anywhere from a few hours to several days.
Aura
If a person goes through this phase, their eyesight may change – lights or strange forms may appear in their field of view. On one side of the body, a person may experience numbness and tingling.
This stage could last anywhere from 5 minutes to an hour.
Phase of a headache
It’s possible that the headache will be severe and throbbing. It usually affects one side of the head, although it can also affect the other.
The migraine must include the following symptoms to be diagnosed as status migrainosus:
- pain that is debilitating, rather than jus
- a headache that lasts longer than 72 hours
A person with status migrainosus may also experience the following symptoms:
Changes in consciousness: Difficulty concentrating and communicating, as well as confusion and sleepiness, are all possible symptoms.
Vomiting and nausea: It’s possible that a person won’t be able to eat or drink, putting them at risk of dehydration and other symptoms.
Other symptoms: These may include weakness and tingling, nasal congestion, pain and stiffness in the neck, anxiety, and low mood.
The pain may temporarily ease with medication, rest, or both.
Diagnosis
There is no reliable test for migraine. Whether a person sees a doctor during or after an episode, the doctor may do the following:
- perform a physical examination
- do other tests to rule out, for example, a stroke or brain injury
- ask about symptoms
- take a medical history
Only migraine people develop status migrainosus.
A doctor may investigate whether a person’s medical history includes the following items to help determine whether they have status migrainosus:
- at least five previous migraine episodes that each lasted 4–72 hours and occurred without an aura
- two previous episodes of migraine with an aura
They may also conduct neurological tests or order an MRI to rule out other problems.
Treatment
Although there is no cure for migraine, drugs can help to reduce the duration of status migrainosus symptoms.
Pain, nausea, and other symptoms are treated with standard therapy. Among the possibilities are:
It’s important to preventing vomiting since dehydration can induce migraines and make symptoms worse.
A doctor may employ specialty medications to assist interrupt the cycle of symptoms in an emergency situation. The following therapies are possible:
- steroids
- muscle relaxants
- antipsychotics
- in rare cases, opioids
- triptans, which tighten the blood vessels
- anti-seizure medication
- antihistamines
The doctor can inject these drugs if the patient is vomiting.
Prevention
There are methods for avoiding migraine attacks and status migrainosus. There are additional methods for reducing the severity or frequency of episodes.
Among the options are:
- anti-seizure drugs
- Botox injections
- antihypertensive drugs
- calcitonin gene-related peptide, or CGRP, pathway monoclonal antibodies
- antidepressants
Acupuncture, biofeedback, and relaxation techniques are some non-drug treatments that may help.
Living with status migrainosus
Living with migraine can be challenging, particularly for those who are prone to status migrainosus.
Migraine can have long-term social, financial, and psychological consequences in addition to the immediate symptoms.
Life with migraine can be tough due to anxiety about an episode occurring, irritation over unmet plans, and a variety of other issues.
Support groups may be beneficial. They also give people the chance to share and learn new ways to deal with symptoms. The Move Against Migraine online group, for example, is run by the American Migraine Foundation.
Counseling may also assist a person in coping with the pain and anxiety that might accompany a chronic condition.
Find more tips for coping with migraine here.
Avoiding triggers
Many migraine people have noticed that certain triggers might set off attacks.
By keeping account of what happened in the days leading up to a migraine attack, including dietary, emotional, and environmental aspects, a person can learn to identify their triggers. The next stage is to figure out how to cut down on your exposure to these triggers.
The following are common status migrainosus triggers:
- weather changes
- infections, such as a cold or the flu
- surgery on the head or face
- hormonal imbalances
- stress
- changes in medication, such as antidepressants or birth control pills
- injuries to the neck or head
- changes in sleeping or eating patterns
Keeping hydrated and getting enough rest can help to lessen the number of episodes you have. Drinking at least 60–80 ounces of water each day is recommended.
Conclusion
The condition known as status migrainosus can be frightening and painful. Understanding what triggers these episodes and taking actions to avoid them might help reduce anxiety and keep the problem from recurring.
A tailored treatment strategy may also assist to avoid or lessen the severity of attacks.
After having status migrainosus, a person should seek further evaluation and counsel from a neurologist who specializes in migraine.
Sources:
- https://www.ccjm.org/content/85/7/514.long
- monoclonal-antibodies/
- https://headaches.org/resources/intractable-migraine/
- https://www.medicalnewstoday.com/articles/320247
- http://www.headaches.org/2007/11/02/case-studies-issue-novemberdecember-2006/
- https://www.ncbi.nlm.nih.gov/books/NBK554611/
- https://www.sciencedirect.com/topics/medicine-and-dentistry/status-migrainosus
- https://www.ichd-3.org/1-migraine/1-4-complications-of-migraine/1-4-1-status-migrainosus/
- https://www.migrainetrust.org/about-migraine/migraine-what-is-it/symptoms-and-stages/
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