Should I Go to the ER for a Migraine?

Medically Reviewed on 5/18/2022

Severe migraine headache

A migraine is a severe throbbing and pulsating headache that causes pain on one side of the head. A patient should visit an emergency department if they have a severe headache with or without nausea and vomiting.
A migraine is a severe throbbing and pulsating headache that causes pain on one side of the head. A patient should visit an emergency department if they have a severe headache with or without nausea and vomiting.

The pain threshold differs from person to person. However, a patient should visit an emergency department if they have a severe headache with or without nausea and vomiting. Individuals usually describe the pain as severe throbbing and pulsating (pain in a series of regular beats or a rhythm) on one side of the head. Migraine symptoms differ from person to person. Generally, migraine headaches last about four hours, but if they are severe they can go on for more than three days. In this situation, a person may need to see a doctor irrespective of the intensity of the pain. Some people may get migraine headaches every few days, whereas others get them once or twice a year.

Things to know about migraine

Types of migraine headaches

Most migraines are with or without aura. Aura refers to sensory disturbances, which include flashes of light, blind spots, and other vision changes with or without tingling/funny sensations on the hands or face. Migraine with aura is a classic presentation of migraine headache. Several hours before the migraine headache starts, the individual feels depressed or may have anxiety with or without tiredness.

Common types of migraines may occur with or without aura and are characterized by one-sided headaches.

Rare types of migraines include

  • Migraine with brainstem aura (silent migraine)
    • Symptoms start suddenly.
    • Symptoms may include speech disturbances, ringing in the ears, vomiting, dizziness, confusion, or loss of balance just before the headache starts.
    • This type of migraine is strongly linked to hormone changes and mainly affects young, adult women.
  • Hemiplegic migraine
    • Symptoms include a short period of paralysis or weakness on one side of the body with temporary numbness, dizziness, or vision changes.
    • It is an emergency condition, so individuals should get emergency help from doctors.
  • Ophthalmic migraine (retinal migraine)
    • This migraine lasts for a few minutes.
    • Symptoms include dull headache (which may later spread to the rest of the head) with partial or complete loss of vision in one eye.
    • Immediate medical help is necessary with persistent visual disturbances.
  • Ophthalmoplegic migraine
    • This type of migraine is a medical emergency because symptoms include pain around the eye with paralysis of the muscles around it (droopy eyelid and vision changes).
  • Status migrainosus (chronic/severe migraine)
    • This is the severe type because it can last for more than 72 hours.
    • The pain and nausea are so intense that hospitalization is needed.

Common signs and symptoms of migraine

The first sign of a migraine is generally eye pain associated with a dull headache. Migraine headache gradually worsens with physical activity. Below are a few other signs that are seen in individuals with migraine

Causes of migraine

The exact cause of migraine headaches is still unknown. As per studies, individuals inherit the triggers that cause migraine headaches (weakness, bright lights, weather changes, etc.). Changes in blood flow in the brain with certain triggers cause migraines. Below are a few common causes that trigger migraine headaches.

  • Stress and tiredness.
  • Change in the sleep cycle.
  • Foods, such as aged cheese, alcohol, and food additives (nitrates and monosodium glutamate or MSG) are responsible for migraines.
  • Skipping meals can also trigger migraine.
  • Migraine headaches during menstruation are usually common in women.
  • Getting too much caffeine or caffeine withdrawal can cause headaches.
  • Changes in the weather, storm fronts, strong winds, or changes in altitude can also trigger a migraine.

Treatment of migraine

Sumatriptan is the drug of choice for treating migraine headaches (should be prescribed by the doctor). The other drugs that help relieve the symptoms include

  • Pain relief and nausea medications: Over-the-counter (OTC) drugs often work well for some people (acetaminophenondansetron, aspirin, caffeine, and ibuprofen).
  • Preventive medicines: They include seizure medicines, blood pressure medicines, and some antidepressants.
  • Biofeedback: The technique helps people with migraines recognize stressful situations and learn to stop the migraine attack.
  • Transcranial magnetic stimulation (TMS): This device, when placed on the back of the head, reduces or stops the pain.
  • Resting in a dark room.
  • Lifestyle modifications and hormonal therapy are usually recommended by doctors to reduce the frequency and intensity of migraines.

Think about what may have caused the attack and avoid that trigger. For example, individuals should avoid drinking red wine if they suspect this is a trigger. Ask the doctor about treatment options to prevent or reduce attacks. Complementary treatments may help, although research is lacking. Examples include relaxation (yoga and meditation), acupuncture, and aromatherapy.


Who suffers more frequently from migraine headaches? See Answer
Medically Reviewed on 5/18/2022
Medscape Medical Reference

Migraine Relief Center