![]() ![]() ![]() This review provides a practical approach to mananging status migrainosus in the outpatient setting including intravenous (IV) options to consider, when available. It is also important to balance some acute treatments with the potential for causing medication-overuse headache, further emphasizing the need for studies to provide clear treatment guidelines. 6 Ideally, a cost-effective, easily administered, stepwise home treatment approach is devised in the outpatient setting before progression into status migrainosus. A study showed the average duration of status migrainosus to be 4.8 weeks, raising the question if resolution was from medical management or the attack self-abating with time. 4,5 There is little data on community incidence and prevalence, 6 but within a neurology practice, an unremitting migraine attack of 72 hours or more is common, especially when superimposed on a background of chronic migraine, which can be a challenge even for the most seasoned neurologist.Īlthough medications are available for treatment, evidence-based guidelines for management of status migrainosus are lacking with no international consensus guidelines and no randomized trials. All-cause headache is estimated to represent approximately one-fourth of neurologic presentations to emergency departments (EDs) the proportion comprised by status migrainosus, which is unknown and estimated to be at least 10%. ![]()
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