Abstract Details

Title Epidemiology and Characteristics of Status Migrainosus in a Tertiary Headache Clinic: A Retrospective Cohort Study

Topic Headache

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 15-019

Objective

Assess epidemiology and characteristics of status migrainosus (SM) in a patient cohort within tertiary care headache clinic to identify the prevalence, 1-year incidence, attack features, treatments, and healthcare utilization for SM.

Background Status migrainosus (SM) is a debilitating migraine attack lasting at least 72 hours according to the International Classification of Headache Disorders 3rd edition (ICHD-3). SM has been poorly characterized.

Design/Methods Retrospective observational cohort study evaluating SM in a subspecialty headache center using chart review from electronic health records (EHR) for patients seen in 2022. Primary endpoint was prevalence and 1-year incidence of reported SM attacks. Wilson score intervals calculated 95% confidence intervals for all proportions. Secondary outcomes assessed clinical features and treatments utilized during SM, using descriptive statistics from those with sufficient detail in EHR.

Results 1184 patients seen in 2022 were screened, of which 1043 (88.1%) were diagnosed with migraine, 458 with any lifetime episode of SM, and 373 meeting inclusion criteria. Median age was 47 (IQR 38, 57) and 87.7% were female (327/373). Nearly 50% reported baseline migraine aura, however prolonged aura during SM was rare. SM prevalence 43.9% (458/1043; 95% CI 40.9%, 46.9%) within the migraine-only population. The 2022 SM incidence in patients with migraine was 21.5% (187/869; 95% CI 18.9%, 24.4%). The median midpoint SM severity was 8/10 (IQR 7-9) with median SM attack duration of 10 days (IQR 4-30, range 3-330 days). SM treatments: migraine specific 48.3% (175/362), nerve blocks 28.8% (68/362), butalbital-containing 1.7% (6/362). 17.7% (64/351) with a recorded emergency department visit and 6.4% (23/360) with a recorded admission.

Conclusions

SM is prevalent within tertiary headache population, affecting ~50% of migraine patients during their lifetime and 1/5 within one year. In this population, patients with SM present as chronic migraine with high rates of aura. This study highlights needs for improved diagnostic consistency and treatment.

Authors/Disclosures
Evelyn Dorsey PRESENTER	Ms. Dorsey has nothing to disclose.
Jennifer V. Robblee, MD (Barrow Neurological Institute)	Dr. Robblee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Impel. Dr. Robblee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Robblee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tonix. An immediate family member of Dr. Robblee has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Scottsdale Providence. The institution of Dr. Robblee has received research support from Eli Lilly. The institution of Dr. Robblee has received research support from AbbVie. The institution of Dr. Robblee has received research support from Barrow Neurological Institute. Dr. Robblee has received publishing royalties from a publication relating to health care. Dr. Robblee has received publishing royalties from a publication relating to health care.

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