Status migrainosus is a migraine attack that lasts longer than 72 hours. Symptoms of a migraine, like throbbing head pain, are usually more severe than expected. You may need treatment in an emergency department, especially if other migraine symptoms set in, like nausea and vomiting.
Status migrainosus is a migraine attack that lasts longer than 72 hours. The symptoms of status migrainosus match what you feel during a typical migraine, with throbbing, one-sided head pain, light sensitivity and nausea. These symptoms can be more intense or severe.
There are four phases to a migraine. The headache attack phase is the stage of a migraine during status migrainosus that lasts longer than expected. A persistent aura can occur, too, and last more than 72 hours.
While migraines are common, migraines that last longer than 72 hours aren’t.
A typical migraine usually goes away within hours or a couple of days. With status migrainosus, the length of a migraine attack affects your ability to function — it’s debilitating. It can take you away from personal and social commitments and make you feel less like yourself.
Yes, status migrainosus can be dangerous. The length of time in which you’ll experience symptoms can affect your physical and mental health. For example, you’re at risk of dehydration if you experience symptoms like nausea and vomiting. When your symptoms don’t improve, it can feel like the world is ending and there’s nothing available to help relieve pain and discomfort. Many cases of status migrainosus result in emergency department visits each year.
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Symptoms of status migrainosus are the same symptoms you feel during a migraine. They last longer than 72 hours and are often more intense. The most common migraine symptoms include:
The exact cause of status migrainosus isn’t well understood. This type of migraine is common after a head injury and some viral infections.
Healthcare providers found that a major contributor to a migraine lasting longer than three days is when your current migraine treatment plan isn’t the right fit for your body’s needs. This could include:
Treating a migraine is a careful balancing act that may take trial and error to get just right. A healthcare provider can help you identify likely causes of your symptoms to help offer better treatment for them.
Triggers are things that cause symptoms to happen. The most common events that trigger status migrainosus include:
A healthcare provider can help you identify and avoid triggers to prevent future migraines.
If you experience migraines, you’re at risk of status migrainosus.
Experiencing migraine symptoms for longer than expected can impact your physical and mental health. It can lead to the following complications:
A healthcare provider will diagnose status migrainosus after a physical exam and neurological exam. During the exams, your provider will ask about your symptoms, your medical history and your biological family medical history. They may use imaging tests or blood tests to rule out conditions with similar symptoms. If you already have a migraine diagnosis, no additional tests are needed.
Your regular migraine medications used to stop a migraine when it happens most likely won’t work to treat status migrainosus.
A different medication or a combination of medications may reduce status migrainosus symptoms, including:
A healthcare provider will give you these medications through an IV (intravenously) using a small needle inserted into a vein in your arm. You may receive medications through an IV continuously for a couple of days in a hospital or outpatient setting. If status migrainosus is a common migraine for you, a healthcare provider may prescribe a version of these medications for you to take at home.
In addition to treating the migraine, a healthcare provider may treat status migrainosus complications at the same time, usually through an IV, which may include:
A healthcare provider may offer medications to prevent the frequency of migraine attacks. They’ll also help you determine if you have any migraine triggers and work with you to avoid those triggers to prevent future migraines.
Status migrainosus can be difficult to experience, as you won’t feel like yourself for several days. This type of migraine can be challenging to treat, as the cause isn’t well understood. It can also be a common occurrence that may result in many emergency room visits. Treatment options are available to help you feel better during a migraine attack and prevent how often they affect you.
By definition, status migrainosus lasts longer than 72 hours. The exact timeframe after 72 hours varies from person to person. While these types of migraines aren’t common, you may experience more than one in your lifetime if you experience migraines.
Contact a healthcare provider or visit the emergency room if you experience migraine symptoms that last longer than 72 hours.
Status migrainosus is an incredibly difficult migraine experience. You won’t feel like yourself for a significant amount of time and the light at the end of the tunnel seems far away. You might choose to visit an emergency room for immediate help, especially if you’re unable to keep fluids down due to vomiting. A provider can also help you identify triggers and how to prevent them.
It’s important to understand that even with migraine treatment, this can happen — and there’s nothing you did to bring it on. But there are steps you can take to reduce your risk by working closely with your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 12/22/2023.
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