Treating status migrainosus in the emergency setting what is the best strategy? /

Introduction: Migraine is a disabling primary headache disorder with unknown exact pathomechanism. Status migrainosus (SM) is a complication of migraine (with or without aura), representing an attack that lasts for more than 72 h. There is a paucity of data published with regard to its pathomechanis...

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Bibliographic Details
Main Authors: Vécsei László
Szok Délia
Nyári Aliz
Tajti János
Format: Article
Published: 2018
Series:EXPERT OPINION ON PHARMACOTHERAPY 19 No. 14
doi:10.1080/14656566.2018.1516205

mtmt:30308958
Online Access:http://publicatio.bibl.u-szeged.hu/14088
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520 3 |a Introduction: Migraine is a disabling primary headache disorder with unknown exact pathomechanism. Status migrainosus (SM) is a complication of migraine (with or without aura), representing an attack that lasts for more than 72 h. There is a paucity of data published with regard to its pathomechanism and therapeutic options. Areas covered: The authors review the literature on SM from PubMed published between 1999 and January 2018. The authors specifically look at the therapeutic possibilities of SM in the emergency department in patients that have or have not already been treated with serotonergic agents. Additional discussion is given to the rare complications of migraine. Expert opinion: SM is a devastating condition; therefore, the primary goal is to prevent its development with proper acute and prophylactic migraine medication. If this treatment fails, the patient should be treated in the emergency setting. Due to the severity of the condition, parenteral pharmacotherapy is recommended. However, high-quality randomized trials are lacking. The currently available data suggest the use of intravenous fluids, corticosteroids, magnesium sulfate, anticonvulsive drugs, nonsteroidal anti-inflammatory drugs, antiemetics, and serotonergic agents for the treatment of SM. Still, there is a need for personalized and causal therapy for migraine sufferers. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. 
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