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

L. Vécsei, Délia Szok, Aliz Nyári, J. Tajti

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1523-1531
Number of pages9
JournalExpert Opinion on Pharmacotherapy
Volume19
Issue number14
DOIs
Publication statusPublished - Sep 22 2018

Fingerprint

Migraine Disorders
Emergencies
Serotonin Agents
Primary Headache Disorders
Migraine without Aura
Therapeutics
Migraine with Aura
Magnesium Sulfate
Antiemetics
Expert Testimony
Non-Steroidal Anti-Inflammatory Agents
PubMed
Anticonvulsants
Hospital Emergency Service
Adrenal Cortex Hormones
Drug Therapy
Pharmaceutical Preparations

Keywords

  • Anticonvulsive drugs
  • antiemetics
  • corticosteroids
  • emergency
  • intravenous hydration
  • magnesium sulfate
  • migraine
  • nonsteroidal anti-inflammatory drugs
  • serotonergic agents
  • status migrainosus
  • treatment

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Treating status migrainosus in the emergency setting : what is the best strategy? / Vécsei, L.; Szok, Délia; Nyári, Aliz; Tajti, J.

In: Expert Opinion on Pharmacotherapy, Vol. 19, No. 14, 22.09.2018, p. 1523-1531.

Research output: Contribution to journalReview article

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