12/10/07 #9 - 72 hours, what constitutes relief?

Ask the Clinician Health Pro
  • Full Question:
    I've heard over and over that if a migraine lasts over 72 hours without 4 hours of relief that I should go to the ER because of the risk of migrainous stroke...but what constitutes relief? Do narcotics count? Do triptans count? If narcotics and other pain relievers count, why? Don't they just mask the pain and have no effect on the state of the blood vessels? Thanks, Tara.





    Dear Tara;


    Everything in life counts. While your questions are far-reaching and thought provoking, on a practical level whatever relieves a Migraine is worth a try. Most Migraine-specific treatments such as triptans are vasoconstrictors, as well as blockers of central pain processing. Opiates enhance the pain reduction system in the brain (endorphins).

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    Although Migrainous stroke is fairly rare, it is far better to treat aggressively each Migraine episode.


    What constitutes relief for the purposes of determining whether it's time to seek emergency care is whether you've had three or four pain-free hours while you're awake. If your Migraine has gone longer than 72 hours without those pain-free hours, it's better to be safe and seek emergency care. See Status Migrainous - The Basics for more information.


    Good luck,
    John Claude Krusz and Teri Robert


    If you need to find a headache and Migraine specialist, please see our listing of patient recommended specialists.


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    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    © Teri Robert and J.C. Krusz, 2007.

    Last updated December 10, 2007.

Published On: December 10, 2007