Do you sometimes get a migraine that makes your head hurt, makes you feel like you're going to vomit, and makes you unable to look at the light? Imagine how it would feel if this migraine lasted for more than three days, not just two. You would feel like you were sick, unable to do anything, and feeling like you were dying? That's the kind of severe, prolonged migraine we're going to talk about today, called status migrainosus.
What exactly is Status Migrainosus?
Simply put, status migrainosus is a migraine that lasts for more than 72 hours, or three days. It includes the same symptoms you would normally experience when you have a migraine. These include a throbbing pain on one side of your head, sensitivity to light, and nausea. However, in status migrainosus, these symptoms can be much more severe and intense than a typical migraine.
We know that a migraine has several stages. In status migrainosus, the headache attack phase lasts longer than expected. Sometimes, the 'aura' that precedes the migraine, such as seeing lights in front of the eyes and difficulty speaking, can last for more than 72 hours.
Although migraines are common, a migraine that lasts more than three days, called status migrainosus, is not very common. A normal migraine will go away in a few hours or a day or two. But with status migrainosus, your daily activities are completely disrupted. It can even ruin your relationships with family and friends. You may feel like you're not yourself.
Is Status Migrainosus Dangerous?
Yes, status migrainosus can be dangerous. Having symptoms for so long can take a toll on your physical and mental health. For example, if you have persistent nausea and vomiting, you may be at risk of dehydration.
Also, when this pain doesn't go away, you may think things like, "Will there ever be a cure for this?" "Will any medicine work for me?" Some people may feel as if the world is ending and there is no help. In fact, many cases of status migrainosus end with a hospital emergency room visit.
What are the symptoms of status migrainosus?
The symptoms of status migrainosus are the same as those you would experience with a regular migraine. The main difference is that they last longer than 72 hours and are often more intense. The most common symptoms are:
- Pain that feels like a sharp throbbing pain on one side of the head or is accompanied by nausea .
- Nausea and vomiting.
- Hypersensitivity to light, sound, and smell (meaning that you can't stand even the slightest light, sound, or smell).
- Difficulty concentrating on anything.
Imagine, your head hurts so much that you can't even get out of bed, you can't even turn on the light in your room, the sound of someone talking is annoying, and the smell of food makes you want to vomit. That's what happens in this situation.
What causes status migrainosus?
The exact cause of status migrainosus is not yet fully understood, but it is common to see migraines after a head injury or certain viral infections.
Doctors have found that the main reason why migraines last longer than three days is that the migraine medication you are currently taking is not working properly for your body. This could be due to the following reasons:
- The dosage of the medicine you are taking may be too high or too low.
- Your body may be getting used to a new medication.
- The time to use medication to stop migraine symptoms, meaning it may be too late after the migraine has started.
Treating migraines is a delicate balancing act. Sometimes it can take a while to find the right medication for you, after trying different medications. Your doctor can help you find the best treatment for your symptoms by looking for possible triggers.
What are the triggers for status migraine?
Triggers are things that cause symptoms to occur or worsen. The main things that can worsen status migrainosus are:
- Stress. With our busy lives, this affects many people.
- Lack of sleep. Not getting enough sleep is a big cause of migraines.
- Skipping meals. Staying hungry is also not good.
- Changes in the medications you usually take.
Your doctor can help you identify these triggers, and then try to avoid them, which can help prevent future migraines.
Who is at higher risk of developing status migrainosus?
The simple answer to this is that if you have migraines, you are also at risk of developing status migrainosus. So it's a good idea for people with migraines to be especially aware of this.
What are the possible complications of Status Migrainosus?
When you have migraine symptoms for longer than expected, it can affect your physical and mental health. This can lead to complications such as:
- Dehydration: This is a decrease in the amount of water in the body. This risk is especially high if you are vomiting.
- Sleep loss: Pain makes it difficult to sleep properly.
- Depression: The ongoing pain and helplessness can lead to depression.
How is Status Migrainosus diagnosed?
A doctor will examine you, especially a neurological exam, to diagnose status migrainosus. During this exam, your doctor will ask you about your symptoms, your medical history, and any medical conditions your family has.
Sometimes, imaging tests or blood tests may be done to rule out other conditions that cause similar symptoms, so you can be sure that you don't have that condition. However, if you have already been diagnosed with migraine, additional tests are usually not needed.
How is Status Migrainosus treated?
Often, the medications you would normally use to stop a migraine once it starts may not work for this condition, status migrainosus.
You may need another medication or a combination of medications to reduce the symptoms of status migrainosus. Examples of these include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.
- Triptans are a class of drugs.
- Corticosteroids.
- Antiseizure medications , for example valproic acid.
- Some medications used to treat mental illness (Antipsychotics) , for example quetiapine, chlorpromazine, and olanzapine.
- Muscle relaxers , for example chlorzoxazone, tizanidine.
A doctor will give you these medications intravenously (IV) , which is a small tube placed in a vein in your arm. You may need to stay in the hospital or outpatient department for a few days and continue to receive the medications through an IV. If you have frequent status epilepticus, your doctor may also prescribe some of these medications for you to take at home.
In addition to treating the migraine, your doctor may also treat complications of status migrainosus at the same time. These are often given through an IV:
- Anti-nausea medications.
- Fluids like saline to prevent dehydration.
How is life with Status Migrainosus? (Outlook)
Status migrainosus is actually a very difficult thing to experience. You don't feel like yourself for days. Treating this type of migraine can be challenging, as the exact cause is still unknown. It can also be a recurring condition, requiring frequent emergency room visits. However, there are treatments that can help you feel better during a migraine attack and reduce how often you get them.
How long does status migrainosus last?
By definition, status migrainosus is something that lasts more than 72 hours. How long it lasts after 72 hours can vary from person to person. Although these types of migraines are uncommon, if you have migraines, you may experience them more than once in your lifetime.
Can Status Migrainosus be prevented?
Yes, to some extent. A doctor can prescribe medications to reduce the frequency of migraine attacks. Your doctor can also help you identify any triggers that make your migraines worse and help you avoid them. By avoiding these triggers, you can help prevent future migraines.
When should I see a doctor?
If you have symptoms of a migraine that last more than 72 hours, you should definitely see a doctor or go to the emergency room. Please do not ignore this. It is very important to seek medical advice immediately, especially if you are unable to keep down fluids due to vomiting.
What questions should I ask my doctor?
When you go to the doctor, don't forget to ask these questions:
- What kind of treatment do you recommend for me?
- Are there any side effects to that treatment?
- How do I identify the triggers that cause me to develop status migrainosus?
- How do I avoid those triggers?
- What can I do to prevent these status migrainous attacks in the future?
Status migrainosus is a truly unbearable migraine experience. You may feel like you're not yourself for a long time, and there's no escape from this. But don't worry.
The most important thing you need to remember (Take-Home Message)
The most important thing is to understand that even if you're taking migraine medication, you can still develop status migrainosus. You didn't do anything to cause it. That means don't think, "Did I do something wrong to cause this?"
But there are things you can do to reduce your risk. This includes working closely with your doctor. They will help you manage your condition and live a normal life. Remember, you are not alone, and never be afraid to ask for help.
Status Migrainosus, Migraine, Severe Migraine, Headache, Migraine Treatment, Migraine Symptoms
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