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Epidemiology and characteristics of status migrainosus in a tertiary headache clinic: A retrospective cohort study.

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Title: Epidemiology and characteristics of status migrainosus in a tertiary headache clinic: A retrospective cohort study.
Authors: Dorsey, Evelyn (AUTHOR), Robblee, Jennifer (AUTHOR)
Source: Headache: The Journal of Head & Face Pain. Jun2026, Vol. 66 Issue 6, p1294-1304. 11p.
Subjects: Migraine prevention, Therapeutic use of monoclonal antibodies, Medical care use, World Wide Web, Documentation, Disease duration, Patients, Research funding, Scientific observation, Hospital admission & discharge, Questionnaires, Tertiary care, Retrospective studies, Descriptive statistics, Hospital emergency services, Longitudinal method, Analgesics, Medical records, Acquisition of data, Electronic health records, Medical appointments, Botulinum toxin, Tryptamine, Clinics, Application software, Confidence intervals, Data analysis software, Disease relapse, Migraine, Nosology, Disease risk factors
Geographic Terms: Arizona
Abstract: Objective: Assess the epidemiology and characteristics of status migrainosus (SM) in a cohort of patients from a tertiary care headache clinic to identify the prevalence, 1‐year incidence, attack features, treatments, and healthcare utilization for SM. Background: SM is a debilitating migraine attack lasting at least 72 h according to the International Classification of Headache Disorders, 3rd edition. SM has not been well characterized. Methods: This retrospective observational cohort study evaluated SM in a subspecialty headache center in Arizona using chart review from electronic health records for patients seen in 2022. The primary endpoints were clinic‐observed lifetime prevalence and 1‐year incidence (January 1 to December 31, 2022) of SM. Secondary outcomes assessed the clinical features and treatments tried for the SM attacks using descriptive statistics from those with sufficient detail available in electronic health records. Results: A total of 1184 patients seen in 2022 were screened; of those, 1043 (88.1%) had a diagnosis of migraine, including 458 patients with any lifetime episode of SM, with 373 meeting inclusion criteria. The median age was 47.0 years (interquartile range [IQR] 38.0, 57.0) and 87.7% were female (327/373). The majority had chronic migraine and nearly half reported a history of aura. The clinic‐observed SM prevalence was 43.9% (458/1043; 95% confidence interval 40.9%, 46.9%) within the migraine‐only population. The 2022 clinic‐observed SM incidence in patients with migraine was 24.2% (187/772; 95% confidence interval 21.3%, 27.4%). The median midpoint SM severity was 8.0/10.0 (IQR 7.0–9.0) with median SM attack duration of 10.0 days (IQR 4.0–30.0, range 3.0–330.0 days). SM treatments included: 48.3% (175/362) migraine‐specific, 40.1% (145/362) NSAIDs, 37.8% (137/362) steroids, 21.3% (77/362) anti‐dopaminergic drugs, 18.8% (68/362) nerve blocks, 23.2% (84/362) new preventive, 4.4% (16/362) opioids, and 1.7% (6/362) butalbital‐containing medications. There were 17.7% (64/361) with a recorded emergency department visit and 6.4% (23/360) with a recorded admission for the SM episode. Conclusion: SM is common in a tertiary headache population, affecting nearly half of specialty clinic patients with migraine over their lifetime and one in five in a single year. In this population, patients with SM tend to have chronic migraine with high rates of aura. This study highlights the need for improved diagnostic consistency and treatment. Plain Language Summary: Status migrainosus is a severe migraine attack that lasts more than 72 h, but we have limited real‐world data on how often it occurs in specialty headache care. We reviewed medical records from patients seen in one tertiary headache center over 1 year to measure how common status migrainosus was and to describe the people affected. Nearly half of patients had a history of status migrainosus and one in five experienced a new episode that year, highlighting the need for consistent diagnosis and evidence‐based treatment strategies. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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DbLabel: Psychology and Behavioral Sciences Collection
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AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
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  Data: Epidemiology and characteristics of status migrainosus in a tertiary headache clinic: A retrospective cohort study.
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  Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. Jun2026, Vol. 66 Issue 6, p1294-1304. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Migraine+prevention%22">Migraine prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+use+of+monoclonal+antibodies%22">Therapeutic use of monoclonal antibodies</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+use%22">Medical care use</searchLink><br /><searchLink fieldCode="DE" term="%22World+Wide+Web%22">World Wide Web</searchLink><br /><searchLink fieldCode="DE" term="%22Documentation%22">Documentation</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+duration%22">Disease duration</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Scientific+observation%22">Scientific observation</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+admission+%26+discharge%22">Hospital admission & discharge</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Tertiary+care%22">Tertiary care</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Analgesics%22">Analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Electronic+health+records%22">Electronic health records</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+appointments%22">Medical appointments</searchLink><br /><searchLink fieldCode="DE" term="%22Botulinum+toxin%22">Botulinum toxin</searchLink><br /><searchLink fieldCode="DE" term="%22Tryptamine%22">Tryptamine</searchLink><br /><searchLink fieldCode="DE" term="%22Clinics%22">Clinics</searchLink><br /><searchLink fieldCode="DE" term="%22Application+software%22">Application software</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Nosology%22">Nosology</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
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  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Arizona%22">Arizona</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Assess the epidemiology and characteristics of status migrainosus (SM) in a cohort of patients from a tertiary care headache clinic to identify the prevalence, 1‐year incidence, attack features, treatments, and healthcare utilization for SM. Background: SM is a debilitating migraine attack lasting at least 72 h according to the International Classification of Headache Disorders, 3rd edition. SM has not been well characterized. Methods: This retrospective observational cohort study evaluated SM in a subspecialty headache center in Arizona using chart review from electronic health records for patients seen in 2022. The primary endpoints were clinic‐observed lifetime prevalence and 1‐year incidence (January 1 to December 31, 2022) of SM. Secondary outcomes assessed the clinical features and treatments tried for the SM attacks using descriptive statistics from those with sufficient detail available in electronic health records. Results: A total of 1184 patients seen in 2022 were screened; of those, 1043 (88.1%) had a diagnosis of migraine, including 458 patients with any lifetime episode of SM, with 373 meeting inclusion criteria. The median age was 47.0 years (interquartile range [IQR] 38.0, 57.0) and 87.7% were female (327/373). The majority had chronic migraine and nearly half reported a history of aura. The clinic‐observed SM prevalence was 43.9% (458/1043; 95% confidence interval 40.9%, 46.9%) within the migraine‐only population. The 2022 clinic‐observed SM incidence in patients with migraine was 24.2% (187/772; 95% confidence interval 21.3%, 27.4%). The median midpoint SM severity was 8.0/10.0 (IQR 7.0–9.0) with median SM attack duration of 10.0 days (IQR 4.0–30.0, range 3.0–330.0 days). SM treatments included: 48.3% (175/362) migraine‐specific, 40.1% (145/362) NSAIDs, 37.8% (137/362) steroids, 21.3% (77/362) anti‐dopaminergic drugs, 18.8% (68/362) nerve blocks, 23.2% (84/362) new preventive, 4.4% (16/362) opioids, and 1.7% (6/362) butalbital‐containing medications. There were 17.7% (64/361) with a recorded emergency department visit and 6.4% (23/360) with a recorded admission for the SM episode. Conclusion: SM is common in a tertiary headache population, affecting nearly half of specialty clinic patients with migraine over their lifetime and one in five in a single year. In this population, patients with SM tend to have chronic migraine with high rates of aura. This study highlights the need for improved diagnostic consistency and treatment. Plain Language Summary: Status migrainosus is a severe migraine attack that lasts more than 72 h, but we have limited real‐world data on how often it occurs in specialty headache care. We reviewed medical records from patients seen in one tertiary headache center over 1 year to measure how common status migrainosus was and to describe the people affected. Nearly half of patients had a history of status migrainosus and one in five experienced a new episode that year, highlighting the need for consistent diagnosis and evidence‐based treatment strategies. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=194722794
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/head.70067
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 1294
    Subjects:
      – SubjectFull: Migraine prevention
        Type: general
      – SubjectFull: Therapeutic use of monoclonal antibodies
        Type: general
      – SubjectFull: Medical care use
        Type: general
      – SubjectFull: World Wide Web
        Type: general
      – SubjectFull: Documentation
        Type: general
      – SubjectFull: Disease duration
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Scientific observation
        Type: general
      – SubjectFull: Hospital admission & discharge
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Tertiary care
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Analgesics
        Type: general
      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Acquisition of data
        Type: general
      – SubjectFull: Electronic health records
        Type: general
      – SubjectFull: Medical appointments
        Type: general
      – SubjectFull: Botulinum toxin
        Type: general
      – SubjectFull: Tryptamine
        Type: general
      – SubjectFull: Clinics
        Type: general
      – SubjectFull: Application software
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Disease relapse
        Type: general
      – SubjectFull: Migraine
        Type: general
      – SubjectFull: Nosology
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
      – SubjectFull: Arizona
        Type: general
    Titles:
      – TitleFull: Epidemiology and characteristics of status migrainosus in a tertiary headache clinic: A retrospective cohort study.
        Type: main
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            – D: 01
              M: 06
              Text: Jun2026
              Type: published
              Y: 2026
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