When To Go To The ER With A Migraine

Migraine is a neurological condition where a person experiences severe throbbing headache on either one or both sides of the head. It often causes extreme sensitivity to sound, lights, nausea, and vomiting. Migraines are often uncalled and can happen at any time of the day. 

Usually, migraines last anywhere between 4 hours to three days. The symptoms and the intensity of it differ from person to person. Some people might only experience throbbing headaches, and others might experience severe pulsating headaches with or without aura, nausea, and vomiting. Migraine often impacts the patient's personal, professional and social life.

Often migraine attacks can be managed with simple medications at home. However, in some people, the pain of the migraine might become so severe that they find it impossible to bear and hence, have to go to the Emergency Room (ER).

To know more about why and when to go to the ER with a migraine, keep reading.

Treatment Of Acute Migraine In The Emergency Department, When To Go?

The threshold of migraine pain is different for everyone. The right time to go to the ER is when you experience unbearable, excruciating pain, an attack worse than the previous one, or if you fear the migraine is associated with something more serious.

Signs To Identify Migraine As A Medical Emergency

Although most of the time, migraines are manageable at home with medications and proper care, there are some instances where the migraine requires instant medical attention. The signs accompanying migraine suggesting immediate medical attention are:

1. When migraine lasts for more than three days: In certain instances, the migraine might not respond to the usual treatments at home and may last for three days or more. This is known as a Status migrainosus. This condition often requires medical attention at the ER.
2. When neurological symptoms last longer than usual / appearance of new symptoms: Slurred speech, difficulty speaking, changes in vision, dizziness, fatigue, and aura are some symptoms that might occur during migraine. When these symptoms occur for the first time or stay longer than usual, admission to the ER may be required.
3. Migraine with severe persistent nausea and vomiting: Nausea and vomiting are common during migraine. However, if nausea and vomiting persist, they might require medical attention as the oral medications might get eliminated due to vomiting. Also, persistent vomiting might cause severe dehydration.
4. Indication of an underlying condition: Frequent migraines can be a sign of an underlying condition like brain tumor, brain hemorrhage, stroke due to migraine, or aneurysm; in such cases going to the ER is necessary.
5. Migraine with fever and neck stiffness: Migraine accompanied by neck stiffness and fever requires medical attention as it can indicate Meningitis (infection on the linings of the brain).
6. Others: Other signs that when occur with migraine must be reported as a medical emergency are numbness, tingling sensations, sudden headache, a headache that becomes severe minutes after its start, muscle weakness, convulsions, lack of balance, one of the eyelids becoming droopy, loss of consciousness, two different sizes of the pupil.

Migraine Treatment In The ER

Once you reach the ER for migraine, the major focus of your healthcare provider would be to examine you and provide treatment urgently. Your doctor will carry out certain tests to check for any underlying condition. These tests include CT scan, MRI scan, and Spinal tap.

Once sure that the migraine isn't due to any underlying condition, then your healthcare provider will provide treatment using medications. Medications are given through the veins or the muscle. The medications that might be administered include:

• Antiemetics (anti-nausea) to help relieve nausea and vomiting
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
• Anti-seizure medication
• Analgesic
• Corticosteroids
• IV fluids to treat dehydration

Conclusion

Migraines can be managed easily at home with the management of their triggers. Simple changes like daily meditation, a healthy lifestyle and not stressing too much, can significantly affect the frequency and severity of migraine. 

Though manageable, the signs and symptoms that get serious and stay longer than usual must not be neglected. Any experience where the headache starts suddenly becomes severe in minutes, uncontrollable nausea or vomiting, or loss of consciousness must not be ignored. All these symptoms might indicate a much larger problem, so admission to the ER must be made instantly.