Status Migrainosus

Migraine is the second most common and disabling disease worldwide,1 and some of the associated disability can be attributed to complications of the disease. Status migrainosus, whereby an attack exceeds 72 hours in duration,2 is a complication of migraine that has historically been very understudied. It is unclear how common it is, given limited data, but the few existing prevalence studies have estimated that anywhere from 3% to 20% of people with migraine may experience status migrainosus.3-5 What little evidence is available suggests that it is a considerable public health problem; it is associated with significant disability,5 and people with status migrainosus have a worse migraine prognosis5 and a higher risk of suicide6 when compared with people with migraine who do not experience status migrainosus. People with status migrainosus are also frequently hospitalized for management,4,5 and admissions are incredibly costly, with estimates varying between ∼USD $3,800 and 7,000 per admission.7,8 Unfortunately, existing inpatient therapies have very low levels of evidence to support their use and may have low efficacy rates.9