Episodic status migrainosus: A novel migraine subtype.

Area of Science:

• Neurology
• Headache Medicine

Background:

• Migraine is a common neurological disorder.
• Status migrainosus is a prolonged migraine attack.
• A novel subtype of prolonged migraine attacks requires characterization.

Purpose of the Study:

• To describe a novel migraine subtype: episodic status migrainosus (ESM).
• To investigate the clinical characteristics and progression of ESM.
• To determine if ESM represents a distinct nosologic entity.

Main Methods:

• Retrospective review of patients diagnosed with status migrainosus at Mayo Clinic (2005-2015).
• Manual review of records to identify patients with migraine attacks exclusively lasting >72 hours.
• Analysis of patient demographics, attack frequency, duration, precipitants, comorbidities, and progression to chronic migraine.

Main Results:

• 18 patients identified with ESM (83.3% female), median age of onset 16.5 years.
• Median attack frequency of 2/month, with attacks lasting a median of 7 days.
• 83.3% of patients progressed to chronic migraine within a median of 7.8 years; no association with attack frequency or duration.

Conclusions:

• Episodic status migrainosus (ESM) is a novel migraine subtype characterized by prolonged attacks (>72 hours).
• ESM shares features with episodic migraine but has a high rate of conversion to chronic migraine.
• Further research is needed to understand the pathophysiology and optimal management of ESM.