1.4.1 Status migrainosus

An accountant describes a headache that has failed to settle, the eighth such episode in her lifetime. Beforehand she felt off-balance and slightly slurred in her speech, symptoms that emerged one after the other rather than together, with a vague sense that things felt worse down one side; within the hour a headache had taken hold on that same side. Her attacks usually resolve within around 28 hours, but on this occasion the headache has run on, without any break, for just over 72 hours, quite unlike her ordinary attacks in how long they last and how severe they get. She has been unable to tolerate light or sound, describes the pain as pounding, and says it has left her totally unable to cope.