Status Migrainous - The Basics

by Teri Robert Patient Advocate

by Teri Robert, MyMigraineConnection Lead Expert

Extended Migraines should not be ignored...__**

What is status Migrainous (also spelled Migrainousus)? Migraine has now been shown to be a genetic neurological disease characterized by flare-ups often called "Migraine attacks." A headache can be one symptom of a Migraine attack, but it's just that -- one of the possible symptoms. Some Migraineurs (people with Migraine disease) have Migraine attacks without having a headache.

When a Migrainuer does experience the headache phase of a Migraine attack, it generally lasts from 4 to 72 hours (untreated or unsuccessfully treated). The International Headache Society's International Classification of Headache Disorders, 2nd Edition, defines status Migrainous as:

Description: A debilitating Migraine attack lasting for more than 72 hours.

Diagnostic Criteria:

A. Typical of previous attacks except for duration.

B. Headache has both of the following features:

  1. unremitting for more than 72 hours

  2. severe intensity

C. Not attributed to another disorder

A general rule of thumb recommended by many Migraine specialists is:

If moderate to severe Migraine pain lasts more than 72 hours, with less than a solid four-hour pain-free period, while awake, it should be considered an emergency requiring an office call or a trip to the emergency room.

Why is it important that status Migrainous be treated? The pain of a Migraine is from dilated blood vessels in the brain and the inflammation of tissue and nerves around those blood vessels. Extended dilation of the blood vessels puts us at increased risk of stroke. Thus, it's important to stop a Migraine attack, as opposed to simply masking the pain with pain medications, as soon as possible.


"The International Classification of Headache Disorders, 2nd Edition." Cephalalgia 24 (s1). doi: 10.1111/j. 1468-2982.2003.00824.x

Teri Robert
Meet Our Writer
Teri Robert

Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation's Patient Partners Award and a Distinguished Service Award from the American Headache Society.