Abstract：
Status migrainosus is one of the recognized complications of migraine with or without aura, defined as a persistent debilitating migraine attack lasting for more than 72h with little reprieve, leading to functional disability. The individual impact of status migrainosus and the substantial healthcare burden are highlighted. Current case series which inform our understanding of this condition are examined with two groups emergent, those with classic status migrainosus and those with episodic status migrainosus. The question as to whether status migrainosus is a distinct biological state beyond the established migraine pathophysiology is examined. With the underlying pathophysiology not fully understood, attention is turned to therapeutic considerations and the available evidence informing practice. A practical approach to treatment of status migrainosus is presented. Given the severity and need for emergency care, options detailed are in line with recommendations for acute migraine care: with a staged approach initially combining subcutaneous sumatriptan with parenteral options including dopamine receptor antagonists, nonsteroidal anti-inflammatories and acetaminophen. The place of combination treatment with parenteral magnesium sulfate, dihydroergotamine, antiepileptics, corticosteroids, and anesthetic agents is outlined. With a paucity of high-quality evidence to consolidate current clinical approaches, consideration of future therapies and research questions is raised.
摘要：
偏头痛状态是公认的有或没有先兆的偏头痛并发症之一，定义为持续衰弱的偏头痛发作，持续超过72小时，几乎没有缓刑，导致功能性残疾。强调了偏头痛的个人影响和巨大的医疗保健负担。当前的病例系列，告知我们对这种情况的理解，用两组紧急，那些有经典状态的偏头痛和那些有偶发状态的偏头痛。研究了偏头痛状态是否超出已建立的偏头痛病理生理学的独特生物学状态的问题。由于潜在的病理生理学尚未完全理解，注意力转向治疗考虑和现有证据告知实践。提出了一种治疗偏头痛的实用方法。鉴于紧急护理的严重性和必要性，详细的选择符合急性偏头痛治疗的建议:采用分阶段的方法，最初将皮下舒马曲坦与包括多巴胺受体拮抗剂在内的肠胃外选择相结合，非甾体抗炎药和对乙酰氨基酚。与肠胃外硫酸镁联合治疗的地方，二氢麦角胺，抗癫痫药,皮质类固醇,和麻醉剂概述。由于缺乏高质量的证据来巩固当前的临床方法，提出了对未来疗法和研究问题的考虑。
