When your head is pounding and you have all the other symptoms of a migraine attack, it’s tempting to head for your nearest emergency room in the hope of finding some relief. But can an ER really help with migraines, or are you just wasting your precious rest time by going?
Let’s take a look at when migraine patients should consider going to the ER, and what they can expect to happen there.
When Migraine is an Emergency
There are definitely times when you should go to the emergency room for a headache, even if you know it is a migraine. Chronic or severe headaches are a common reason for ER visits, mainly because they can be signs of a wide range of other critical conditions. It’s important to seek emergency care if you experience symptoms that are new for you, according to the American Migraine Foundation, especially if these include fever, vision problems, weakness or mental confusion. A headache or migraine that lasts for days or weeks is also often a good reason for an ER visit, when patients reach the end of their pain tolerance. People with serious chronic illnesses such as heart, liver and kidney disease or an autoimmune condition should take extra care.
What the ER Will Do
Emergency room doctors are seldom headache specialists, so the best they can do is run tests to determine whether the pain is linked to another medical condition. If the test results show your headache is caused by aneurysm, stroke, meningitis or a brain hemorrhage, for example, the first step would be to take steps to treat the underlying problem.
One of the first tests most ERs run is a drug panel, to determine whether you are a user. The opioid epidemic is a serious global problem and users often experience rebound headaches that mimic migraine attacks.
If you’re identified as a legitimate migraine patient, or the team on duty is unable to uncover a medical condition requiring emergency care, they will likely try to stabilize the pain and refer you to a headache specialist for further examination. In extreme cases where the patient is unable to function physically, the ER may hospitalize them and call in a practitioner with the appropriate skills. For patients with signs of vomiting or dehydration, the ER might administer IV fluids along with pain medications.
Don’t Wait for It to Happen
The most important aspect of successfully treating chronic migraine is to be prepared before you have an emergency. Most long-term migraineurs have developed particularly bad headaches at one time or another, and if you’re experienced at dealing with your pain it’s worth going to an emergency room only if you identify unfamiliar symptoms. Ask your regular migraine specialist ahead of time what you should do in case of emergency. He (or she) may well be able to recommend an ER or urgent care clinic that has some knowledge of migraine patients. At the very least, he will be able to provide you with advice on how to proceed, what to take with you when you go to the ER and how to explain your condition. If possible, ask for a note you can keep with your emergency medicine kit that explains the type of migraines you experience, the medication you are taking and the steps to follow in the event of an unmanageable headache. All of this will be tremendously helpful for an emergency room medical team with an acute migraine suddenly thrust upon them.
When You Need Emergency Migraine Care
Having said all this, the way you feel is your most important barometer to guide whether you go to an emergency room or not. Build a close relationship with your migraine doctor so you have all the knowledge you need to manage your condition without panicking, and ensure that your migraine and other medications don’t ever run out. Document your triggers and attacks in a migraine diary and discuss the risk of these triggers occurring randomly with your headache practitioner. If you’re able to identify the signs of a particularly bad migraine, you may be able to take steps to avoid it.