Have you heard that migraine attacks only last between 4 and 72 hours? Many people believe this to be true, but unfortunately, it’s a myth. In fact, migraine attacks can last much longer than a few hours or a few days, sometimes lasting weeks, months, or even years.
What Is Status Migrainosus?
According to the American Migraine Foundation, status migrainosus is a migraine attack that lasts longer than 72 hours. Sometimes they are called intractable migraine. These long-lasting attacks often do not respond to usual migraine treatments, and the pain can be relentless and debilitating. As with most chronic or episodic attacks, status migrainosus is triggered by lack of sleep, stress, scents, certain foods, skipping meals, and changes in the weather.
Symptoms of status migrainosus may include, but are not limited to:
Moderate to severe throbbing, pounding or stabbing pain on one or both sides of the head - Dizziness or vertigo
- Sensitivity to light, sound and/or smell
- Sensitivity to movement
- Nausea and/or vomiting
- Fatigue
- Difficulty concentrating
- Speech changes
- Visual changes
- Depression and/or anxiety
If you have been experiencing any of the above symptoms for 72 hours or more, talk with your doctor immediately.
Treatment
The first steps to treating status migrainosus are likely to be taken at home. Remember to take medications and migraine devices (prescribed or over-the-counter) at the first sign of a migraine attack. Use other at-home treatments to ease or stop the pain and other symptoms, including:
- Stay hydrated. Drink plenty of water and hydrating fluids. Avoid alcohol since it is dehydrating.
- Eat if you can. Even small meals or healthy snacks may help with nausea. Avoid foods that may worsen symptoms like chocolate.
- Rest. If possible, stop what you’re doing and rest or get some sleep.
- Ice or heat therapy. Using an ice cap or heating pad on your neck can help reduce pain and muscle stiffness.
- Use a migraine device like Nerivio, Cefaly, Relivion, SAVI Dual, and gammaCore.
- Wear migraine glasses to reduce your sensitivity to light.
- Try relaxing activities. Listening to music, audiobooks, knitting, or doing a jigsaw puzzle may help you relax and stop focusing on your pain.
- Be mindful. Mindful practices like meditation, calming mantras, or even gentle movement can help.
- Diffuse essential oils – but only if they are not a trigger for you!
More treatment options are available in our Migraine Toolbox, and you can also watch our video with Dr. Berk about treating status migrainosus.
At times, normal treatments are not enough to relieve migraine symptoms, and you may need to call your headache doctor for additional options or even visit an emergency room or urgent care. Additional treatments may include steroids, nerve blocks, anti-nausea medications, toradol, intravenous fluids, and more.
Print our Migraine Treatment Options guide and bring it to your next doctor visit. Work with your migraine specialist to develop a written treatment plan that details how to manage migraine attacks and when urgent medical care is needed. If you don’t have a migraine specialist, you can find one using our free locator.
Prevention
Unfortunately, it’s not possible to prevent every migraine attack. But, there are things we can do to help prevent some attacks and keep others from getting worse or becoming intractable.
- Take preventive medication as directed.
- Use preventative migraine devices like Cefaly, Nerivio, Relivion, SAVI Dual and gammaCore.
- Treat your comorbid conditions like TMJ, PTSD, and insomnia.
- Practice stress management techniques like mindful breathing and meditation.
- Incorporate regular physical activity into your day that does not trigger your attacks.
- Stay hydrated and don’t skip meals.
- Try complementary treatments like acupuncture, biofeedback and massage therapy.
- Talk with your doctor about supplements like B2 and magnesium.
- Get plenty of sleep.
- Join our migraine community support group.
It is possible for any migraine attack to become status migrainosus. By following your prevention and treatment plans, you can help avoid, reduce, or stop the pain of an intractable migraine attack, and help reduce the chance of needing to visit the emergency room.