{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:24:38Z","timestamp":1792819478984,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009797","name":"Barrow Neurological Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009797","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Identify how the American Headache Society (AHS) membership manages status migrainosus (SM) among outpatients.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n SM is defined as a debilitating migraine attack lasting more than 72\u2009h. There is no standard of care for SM, including whether a 72\u2010h duration is required before the attack can be treated as SM.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The Refractory Headache Special Interest Group from AHS developed a four\u2010question survey distributed to AHS members enquiring (1) whether they treat severe refractory migraine attacks the same as SM regardless of duration, (2) what their first step in SM management is, (3) what the top three medications they use for SM are, and (4) whether they are United Council for Neurologic Subspecialties (UCNS) certified. The survey was conducted in January 2022. Descriptive statistical analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Responses were received from 196 of 1859 (10.5%) AHS members; 64.3% were UCNS certified in headache management. Respondents treated 69.4% (136\/196) of patients with a severe refractory migraine attack as SM before the 72\u2010h period had elapsed. Most (76.0%, 149\/196) chose \u201ctreat remotely using outpatient medications at home\u201d as the first step, 11.2% (22\/196) preferred procedures, 6.1% (12\/196) favored an infusion center, 6.1% (12\/196) sent patients to the emergency department (ED) or urgent care, and 0.5% (1\/196) preferred direct hospital admission. The top five preferred medications were as follows: (1) corticosteroids (71.4%, 140\/196), (2) nonsteroidal anti\u2010inflammatory drugs (NSAIDs) (50.1%, 99\/196), (3) neuroleptics (46.9%, 92\/196), (4) triptans (30.6%, 60\/196), and (5) dihydroergotamine (DHE) (21.4%, 42\/196).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Healthcare professionals with expertise in headache medicine typically treated severe migraine attacks early and did not wait 72\u2009h to fulfill the diagnostic criteria for SM. Outpatient management with one or more medications for home use was preferred by most respondents; few opted for ED referrals. Finally, corticosteroids, NSAIDs, neuroleptics, triptans, and DHE were the top five preferred treatments for home SM management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.14769","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T04:20:03Z","timestamp":1719980403000},"page":"1040-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Real\u2010world approaches to outpatient treatment of status migrainosus: A survey study"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-1125","authenticated-orcid":false,"given":"Jennifer","family":"Robblee","sequence":"first","affiliation":[{"name":"Department of Neurology, Lewis Headache Center Barrow Neurological Institute, St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulia Y.","family":"Orlova","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Global Specialty R&D, Neuroscience at Teva Pharmaceuticals West Chester Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashhar S.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurology, Henry Ford Health System Wayne State University School of Medicine Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Birlea","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Colorado Denver SOM Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-5394","authenticated-orcid":false,"suffix":"IV","given":"Larry","family":"Charleston","sequence":"additional","affiliation":[{"name":"Department of Neurology and Ophthalmology Michigan State University College of Human Medicine East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjan N.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Missouri St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Nattan P.","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital das Cl\u00ednicas University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"The International Classification of Headache Disorders, 3rd edition","volume":"38","author":"IHS","year":"2018","journal-title":"Cephalgia"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1177\/0333102414520763","article-title":"Status migrainosus and migraine aura status in a French tertiary\u2010care center: an 11\u2010year retrospective analysis","volume":"34","author":"Beltramone M","year":"2014","journal-title":"Cephalalgia"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/j.1526-4610.2006.00608.x","article-title":"A clinical study of migraine evolution","volume":"46","author":"Pryse\u2010Phillips W","year":"2006","journal-title":"Headache"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.1212\/WNL.0000000000201382","article-title":"Incidence of status migrainosus in Olmsted County, Minnesota, United States: characterization and predictors of recurrence","volume":"100","author":"VanderPluym JH","year":"2023","journal-title":"Neurology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/0333102420911461","article-title":"Unrecognized challenges of treating status migrainosus: an observational study","volume":"40","author":"Iljazi A","year":"2020","journal-title":"Cephalalgia"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1177\/0333102416686341","article-title":"Episodic status migrainosus: a novel migraine subtype","volume":"38","author":"Singh TD","year":"2018","journal-title":"Cephalalgia"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1212\/WNL.0000000000201477","article-title":"Status migrainosus: one of the most poorly understood but important complications of migraine","volume":"100","author":"Orr SL","year":"2022","journal-title":"Neurology"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/head.13767","article-title":"The profile and prognosis of youth with status migrainosus: results from an observational study","volume":"60","author":"Orr SL","year":"2020","journal-title":"Headache"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/1941874416641467","article-title":"Predictors of prolonged hospital stay in status migrainosus","volume":"6","author":"Modi SY","year":"2016","journal-title":"Neurohospitalist"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.pediatrneurol.2016.09.009","article-title":"Outcome and cost of inpatient hospitalization for intravenous dihydroergotamine treatment of refractory pediatric headache","volume":"66","author":"Nelson GR","year":"2017","journal-title":"Pediatr Neurol"},{"issue":"9","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm7090269","article-title":"Risk and predisposing factors for suicide attempts in patients with migraine and status migrainosus: a nationwide population\u2010based study","volume":"7","author":"Harnod T","year":"2018","journal-title":"J Clin Med"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/j.1526-4610.1983.hed2303094.x","article-title":"Status migrainosus: causative and therapeutic aspects","volume":"23","author":"Couch JR","year":"1983","journal-title":"Headache"},{"issue":"1721","key":"e_1_2_11_14_1","first-page":"e1723","article-title":"Vertebral artery dissection mimicking status migrainosus","volume":"31","author":"Teodoro T","year":"2013","journal-title":"Am J Emerg Med"},{"issue":"9","key":"e_1_2_11_15_1","first-page":"502","article-title":"Bilateral carotid dissection presenting as status migrainosus: all that glitters is not gold","volume":"5","author":"Rodriguez Sainz A","year":"2014","journal-title":"J Med Case"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1111\/head.13046","article-title":"Pituitary apoplexy presenting as status migrainosus","volume":"57","author":"Shabas D","year":"2017","journal-title":"Headache"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1177\/0333102411433042","article-title":"Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study","volume":"32","author":"Lanteri\u2010Minet M","year":"2012","journal-title":"Cephalalgia"},{"issue":"2","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1468-2982.2008.01689.x","article-title":"The \u2018Act when Mild\u2019 (AwM) study: a step forward in our understanding of early treatment in acute migraine","volume":"28","author":"Goadsby PJ","year":"2008","journal-title":"Cephalalgia"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/ana.10786","article-title":"Defeating migraine pain with triptans: a race against the development of cutaneous allodynia","volume":"55","author":"Burstein R","year":"2004","journal-title":"Ann Neurol"},{"key":"e_1_2_11_20_1","unstructured":"Australia M.Stigma survey: migraine stigma affects 94% of people living with migraine.2020."},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1111\/head.14172","article-title":"Headache infusion centers: a survey on treatments provided, infusion center operations, and barriers to developing new infusion centers","volume":"61","author":"Strauss LD","year":"2021","journal-title":"Headache"},{"issue":"2","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/j.1526-4610.1990.hed30s2550.x","article-title":"Treatment of status migrainosus: the American experience","volume":"30","author":"Raskin NH","year":"1990","journal-title":"Headache"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1111\/head.12835","article-title":"Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies","volume":"56","author":"Orr SL","year":"2016","journal-title":"Headache"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-059647","article-title":"Status migrainosus inpatient treatment with eptinezumab (SMITE): study protocol for a randomised controlled trial","volume":"12","author":"Ray JC","year":"2022","journal-title":"BMJ Open"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1177\/1941874420972593","article-title":"The association between hospital length of stay and treatment with IV magnesium in patients with status migrainosus","volume":"11","author":"Hoffman W","year":"2021","journal-title":"Neurohospitalist"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1046\/j.1468-2982.2002.00364.x","article-title":"Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura. A randomized, double\u2010blind, placebo\u2010controlled study","volume":"22","author":"Bigal ME","year":"2002","journal-title":"Cephalalgia"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.clineuro.2019.01.007","article-title":"Experiences of an outpatient infusion center with intravenous magnesium therapy for status migrainosus","volume":"178","author":"Xu F","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.clineuro.2014.01.002","article-title":"Intra\u2010venous chlorpromazine with fluid treatment in status migrainosus","volume":"119","author":"Utku U","year":"2014","journal-title":"Clin Neurol Neurosurg"},{"key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/j.1526-4610.2009.01603.x","article-title":"Methylprednisolone for status migrainous vertigo and cephalic status migrainosus","volume":"50","author":"Robbins MS","year":"2010","journal-title":"Headache"},{"key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"1321.e1","DOI":"10.1016\/j.ajem.2018.03.054","article-title":"Use of occipital nerve block in emergency department treatment of status migrainosus","volume":"36","author":"Yanuck J","year":"2018","journal-title":"Am J Emerg Med"},{"key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/head.13390","article-title":"The effect of regional anesthetic sphenopalatine ganglion block on self\u2010reported pain in patients with status migrainosus","volume":"59","author":"Mehta D","year":"2019","journal-title":"Headache"},{"key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/NRL.0000000000000161","article-title":"Continuous intravenous valproate as abortive therapy for pediatric status migrainosus","volume":"23","author":"Zafar MS","year":"2018","journal-title":"Neurologist"},{"key":"e_1_2_11_33_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s10072-017-2883-z","article-title":"Intravenous mannitol in status migrainosus treatment: a clinical case series","volume":"38","author":"De Simone R","year":"2017","journal-title":"Neurol Sci"},{"key":"e_1_2_11_34_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s10194-007-0378-7","article-title":"Role of intravenous levetiracetam in status migrainosus","volume":"8","author":"Farooq MU","year":"2007","journal-title":"J Headache Pain"},{"key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1046\/j.1526-4610.1997.3706377.x","article-title":"Droperidol treatment of status migrainosus and refractory migraine","volume":"37","author":"Wang SJ","year":"1997","journal-title":"Headache"},{"key":"e_1_2_11_36_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/1941874416651118","article-title":"Ziprasidone as a potential abortive therapy for status migrainosus","volume":"6","author":"Landsness EC","year":"2016","journal-title":"Neurohospitalist"},{"key":"e_1_2_11_37_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2019.00201","article-title":"Short term oral methylergonovine maleate prophylaxis for status migrainosus. Case series and review of literature","volume":"10","author":"Haque N","year":"2019","journal-title":"Front Neurol"},{"key":"e_1_2_11_38_1","first-page":"1199","article-title":"The first world report of botulinum A toxin injection for status migrainosus","volume":"84","author":"Poungvarin N","year":"2001","journal-title":"J Med Assoc Thail"},{"key":"e_1_2_11_39_1","first-page":"407","article-title":"Treatment of status migrainosus by general anesthesia: a case report","volume":"65","author":"Udelsmann A","year":"2015","journal-title":"Braz J Anesthesiol"},{"key":"e_1_2_11_40_1","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1111\/j.1468-1331.2009.02748.x","article-title":"EFNS guideline on the drug treatment of migraine\u2013revised report of an EFNS task force","volume":"16","author":"Evers S","year":"2009","journal-title":"Eur J Neurol"},{"key":"e_1_2_11_41_1","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1111\/head.14153","article-title":"The American Headache Society Consensus Statement: update on integrating new migraine treatments into clinical practice","volume":"61","author":"Ailani J","year":"2021","journal-title":"Headache"},{"key":"e_1_2_11_42_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1177\/0333102414535997","article-title":"Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings","volume":"35","author":"Orr SL","year":"2015","journal-title":"Cephalalgia"},{"key":"e_1_2_11_43_1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1046\/j.1526-4610.2002.02207.x","article-title":"Volume and nature of telephone calls in a specialty headache practice","volume":"42","author":"Loder E","year":"2002","journal-title":"Headache"},{"key":"e_1_2_11_44_1","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1111\/head.13339","article-title":"Do headache patients require more care in between visits than other neurology outpatients?","volume":"58","author":"Brilla R","year":"2018","journal-title":"Headache"},{"key":"e_1_2_11_45_1","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1111\/head.12939","article-title":"Patterns of use of peripheral nerve blocks and trigger point injections for pediatric headache: results of a survey of the American Headache Society Pediatric and Adolescent Section","volume":"56","author":"Szperka CL","year":"2016","journal-title":"Headache"},{"key":"e_1_2_11_46_1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1111\/j.1526-4610.2010.01676.x","article-title":"Patterns of use of peripheral nerve blocks and trigger point injections among headache practitioners in the USA: results of the American headache society interventional procedure survey (AHS\u2010IPS)","volume":"50","author":"Blumenfeld A","year":"2010","journal-title":"Headache"},{"issue":"5","key":"e_1_2_11_47_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11051401","article-title":"Trends in the management of headache disorders in US emergency departments: analysis of 2007\u20102018 National Hospital Ambulatory Medical Care Survey data","volume":"11","author":"Yang S","year":"2022","journal-title":"J Clin Med"},{"key":"e_1_2_11_48_1","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1111\/head.12233","article-title":"Choosing wisely in headache medicine: the American Headache Society's list of five things physicians and patients should question","volume":"53","author":"Loder E","year":"2013","journal-title":"Headache"},{"key":"e_1_2_11_49_1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s11916-009-0048-3","article-title":"Overuse of acute migraine medications and migraine chronification","volume":"13","author":"Bigal ME","year":"2009","journal-title":"Curr Pain Headache Rep"},{"key":"e_1_2_11_50_1","doi-asserted-by":"crossref","first-page":"4388","DOI":"10.1007\/s00415-021-10610-w","article-title":"Navigating migraine care through the COVID\u201019 pandemic: an update","volume":"268","author":"Angus\u2010Leppan H","year":"2021","journal-title":"J Neurol"},{"key":"e_1_2_11_51_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1186\/s12883-021-02378-3","article-title":"Impact of COVID\u201019 pandemic on migraine management in the United States: insights from migraine tracking app users","volume":"21","author":"Kato Y","year":"2021","journal-title":"BMC Neurol"},{"key":"e_1_2_11_52_1","first-page":"31","article-title":"Teleneurology for primary headache disorders","author":"Robblee J","year":"2020","journal-title":"Pract Neurol"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14769","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:32:02Z","timestamp":1762083122000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,3]]},"references-count":51,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/head.14769"],"URL":"https:\/\/doi.org\/10.1111\/head.14769","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,3]]},"assertion":[{"value":"2024-03-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}