Migraine can be an intense disease that causes pain, sensitivities to light and sound, and nausea and vomiting. This can affect your quality of life, leading to missed work, school days, and important life events.

For some, the pain may be so severe that they have to go to the emergency room (ER). In fact, migraine prompts about 3.5 million ER visits in the United States per year.

If you have a diagnosis of migraine, it’s important to be aware of serious signs that may require emergency medical treatment. Here are the signs that you should consider a visit to the ER.

Getting emergency medical help may be a good option if you’re experiencing new and unusual symptoms. Another reason is if your headache doesn’t respond to or worsens with your regular treatment.

Most times, people who decide to go to the ER experience a new level of pain that’s more severe than a previous migraine.

Get immediate medical attention if your migraine comes with the following:

  • sudden onset headache or a sudden change in baseline headache
  • neck stiffness
  • a high fever
  • muscle weakness
  • changes to speech or vision
  • numbness or tingling sensation
  • convulsions
  • confusion or changes in awareness
  • facial drooping/weakness

A migraine headache that comes on within seconds, particularly if you’re over the age of 50, is a sign that you need to get emergency medical help.

Sometimes, headache and associated symptoms could indicate a more serious underlying medical emergency, such as a stroke.

If you have a history of stroke, heart disease, or diseases of the liver or kidneys, consider taking extra precautions. A new or changing headache could indicate a life threatening emergency.

Migraine with aura may increase your risk for stroke in the future. This type of migraine includes vision changes or neurological symptoms that usually occur before the actual headache.

If you have regular migraine with aura, talk with your doctor about emergency medical symptoms to watch for.

The primary role of an ER is to evaluate and treat conditions urgently. If you go to the ER for a migraine and have any unusual symptoms, the ER doctor will likely order brain imaging to rule out a stroke or aneurysm.

If you don’t have any unusual symptoms, you may not need any diagnostic imaging tests. Your ER doctor will instead ask you questions about your headache and the medications you currently take.

If necessary, your ER doctor can provide medications to help temporarily alleviate your migraine until you can consult your regular doctor.

Headache medications can be given intravenously (IV) or intramuscularly. These include:

  • antiemetics to help relieve nausea and pain
  • dihydroergotamine, specifically used for prolonged migraine treatment
  • nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids to reduce inflammation and pain
  • sumatriptan, which provides urgent migraine relief
  • valproic acid, an anti-seizure medication used for headache relief
  • diphenhydramine (Benadryl), an antihistamine that can help relieve migraine symptoms

Sometimes, an ER doctor may prescribe you opioids, but this is rare. This is because of potential side effects and the risk of dependence.

In addition to pain-relieving medications, your ER doctor may provide fluids via IV if you’re experiencing dehydration.

While migraine is a manageable condition, it’s important to recognize danger signs that warrant a visit to the ER.

If you experience a sudden-onset headache with other serious symptoms, it’s important you go to the ER.

The ER can provide medications to temporarily alleviate pain, but you will likely need a long-term treatment plan.

Be sure to contact your regular doctor as soon as you can to go over your treatment plan. You’ll also want to bring your discharge notes with you.