Status Migrainosus also known as Status Migraine, Intractable Migraine, and Pernicious Migraine is defined as a severe Migraine a headache without aura which is classified as a complication of a migraine. A migraine headache attack that lasts for more than 72 hours is called Status Migrainosus. In 1978, David Taverner invented the term Status Migrainosus and at which time he described that patients could have dehydration with prolonged, resistant and severe migraine attacks that resulted in weakness. A typical migraine can sometimes turn into status migrainous.
A migraine headache can cause intense throbbing or a pulsating sensation on one side of the head and is complemented by nausea, vomiting, sensitivity to light and sound. All migraines are classified in two ways, migraine with aura and migraine without aura.
Auras are sensory actions that involve other senses but most are visual which may lead to a migraine. Whereas migraines are not considered mortal, status migraines are considered to be a risk factor for stroke and suicide.
Symptoms of Status Migrainosus
There is a difference between status migraines and the regular migraine with aura and migraine without aura. In status migrainosus, the symptoms are continuous for more than 72 hours and in a migraine the headache lasts between 4 and 72 hours. The symptoms of status migraines are related to symptoms of a regular migraine. The common symptoms include:
- Sensitivity to light or other visual changes
- Nausea and vomiting
- Dehydration
- Fatigue due to sleep loss
- Throbbing pain on one side of the head
- Tingling and numbness
- Pain worsened by physical activity like walking
- Sensitivity to sound
- Speech disturbances
- Confusion
- Dizziness
A Migraine sufferer telling her experience about hemiplegic status migrainosus
Causes of Status Migrainosus
Broadly, like other typical migraines, the status migrainous cause is still unknown. Irrespective of the unknown cause there are precipitating factors that can lead to typical migraines, some of them can be specific triggers for status migraines.
Triggers of Status Migrainosus
- Emotional stress or anxiety- stress or anxiety at work or home
- Depression
- Medications especially those prescribed to prevent or relieve migraines
- Diet- skipping meals or fasting, aged cheese, salty and processed foods
- Hormonal causes- women with a history of migraines report headaches before or during their periods. For some others, they have a tendency to develop migraines during pregnancy or menopause.
Diagnosis for Status Migrainosus
First, a precise diagnosis of a status migraine versus other migraine headaches is made. The diagnosis is done depending on the patient migraine attack by examining the duration of the attack like if it more than 72 hours and severe intensity. Status migraines may often cause by medication overuse (MOH).
Status Migrainosus Treatment
The treatment of status migraines can be complicated. Status migraine attacks do not react to normal treatments of a migraine. Many times status migraines are treated in an emergency room of the hospital and the treatment includes intravenous (IV) fluids and medicines to control vomiting and nausea, like Metoclopramide (Reglan) and Prochlorperazine (Compazine).
Medications used to stop a status migraine may include Triptans like Sumatriptan and anti-seizure medications. The longer the condition has been present, the less it tends to respond.