1.4.1 Status migrainosus

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

Diagnostic criteria:
A. A headache attack fulfilling criteria B and C
B. Occurring in a patient with 1.1 Migraine without aura and/or 1.2 Migraine with aura, and typical of previous attacks except for its duration and severity
C. Both of the following characteristics:

    1. unremitting for >72 hr1
    2. pain and/or associated symptoms are debilitating2

D. Not better accounted for by another ICHD-3 diagnosis.

Notes:
1. Remissions of up to 12 hours due to medication or sleep are accepted.

2. Milder cases, not meeting criterion C2, are coded 1.5.1 Probable migraine without aura.

Comments:
Headache with the features of 1.4.1 Status migrainosus may often be caused by medication overuse. When headache in these circumstances meets the criteria for 8.2 Medication-overuse headache, code for 1.3 Chronic migraine and 8.2 Medication overuse headache but not for 1.4.1 Status migrainosus. When overuse of medication is of shorter duration than three months, code for the appropriate migraine subtype(s) only.

Non-debilitating attacks lasting more than 72 hours but otherwise meeting these criteria are coded as 1.5.1 Probable migraine without aura.