• Shruti GOCHHWAL

Status Migrainosus: What Is an Intractable Migraine?

Severe headaches that are characterized by throbbing pain and sensitivity to sound and light are called migraines. Intractable migraine with status migrainosus are prolonged migraine headaches that last for longer than 72 hours. This kind of migraine is very rare and affects only 1% of the population in any given area. It requires an immediate hospital visit as the pain becomes too difficult for the person to handle for such a long time.

It differs from non intractable migraine with status migrainosus, in which the patient experiences the pain for not more than 72 hours. This type of headache can be managed with the help of medicines.

What Are the Symptoms of Status Migrainosus?

intractable migraine with status migrainosus icd 10

Person getting migraine headache, Credits: Pixabay


The most distinguishing feature of status migrainosus is that the headache that a person feels refuses to go away for more than two days. All of its symptoms are prolonged. It is difficult to treat them with regular migraine medications.

You can experience the following symptoms:

  1. An intense throbbing ache on either one or both sides of your head.

  2. Nausea accompanied by vomiting

  3. Sensitivity to light, noise, and sounds

  4. Dizziness and fatigue

When finally the symptoms begin to subside, the person may experience a kind of migraine ‘hangover’. It again lasts for several days.

Intractable migraine with status migrainosus icd 10 is G43.111 . Other migraine with status migrainosus intractable icd 10 is G43.811

There is a very high possibility that the symptoms in this condition will get worse, requiring a visit to the hospital.

What Is Migraine without Aura?

Aura is a phase in the migraine where the person experiences vision changes. This vision change typically takes place in the form of unusual formations in the person’s line of vision. An intractable migraine with aura without status migrainosus is not as disturbing to a person’s functioning as the one with aura.

But intractable migraine without comes with various phases that are very distressing for the person. They are:

  1. Premonitory phase

  2. Headache phase

  3. Postdrome phase

1.   Premonitory Phase

mood swings

Diagram showing mood swings in a person, Credits: Pixabay


This phase is experienced by the person hours or days before the migraine attack. It can be seen as a warning before the beginning of the headache. It can happen in both intractable migraine without aura and with aura. The person may feel the following symptoms:

  1. Food cravings

  2. Mood swings

  3. Irregular bowel movements

  4. Stiffness of neck muscles

  5. Exhaustion

  6. Increase frequency of urination

  7. Sensitivity to light and sound

2.   Headache Phase

intractable migraine with status migrainosus

Person experiencing headache, Credits: Pixabay


The pain of this migraine ranges from being moderate to severe. It becomes severe when it is left untreated. Common characteristics of the headache phase are:

  1. Head pain lasting from 4-72 hours

  2. Moderate to severe intensity of pain

  3. A constant throbbing pain

  4. Headache that worsens with physical exertion

  5. Nausea followed by vomiting

  6. Light and sound sensitivity

3.   Postdrome Phase

non intractable migraine with status migrainosus

Person feeling depressed, Credits: Pixabay


This is the hangover phase that patients experience after the headache. It may take patients a while to recover. They may complain about feeling like a zombie. Its symptoms include:

  1. Feeling low or depressed

  2. Fatigue

  3. Inability to concentrate

Treatment of Status Migrainosus

migraine treatment

Person getting migraine treatment, Credits: Pixabay


Treatment plans for these kinds of migraine attacks include the following:

  1. Acute medication that is administered at the beginning of a migraine attack

  2. Medications to prevent and reduce the occurrence of headache attacks

  3. Preventive treatments such as cognitive behavioral therapy and biofeedback

  4. Examining mental health conditions like depression, anxiety, obesity , etc.

Migraine attacks can affect anybody. Leaving it undiagnosed and untreated will only make your symptoms worse. Reach out to a doctor if you are not able to manage the pain.

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