When to Go to the ER for Migraines & How to Avoid ER Migraine Treatment 

severe migraine treatment dallas

More than 10% of Americans suffer from migraine headaches. Every year, one in seven of these people will go to the emergency room for severe migraine treatment. In fact, some of them will go several times a year.

But what can they do in the emergency room for migraines? Are there side effects of severe migraine treatment?

In the following post, migraine experts at the Pain Relief Center in Plano, Texas will give a quick background on migraine headaches, describe migraine emergency room treatment and the options for those who suffer from severe migraines.

What is a Migraine?

Migraines are a neurological event associated with severe headaches. They can last from 4 hours to 3 days.

Though many people see migraines as no more than severe headaches, they are far more complicated. Some of the symptoms of migraines are:

  • Severe headache, with throbbing on one side of the head
  • Sensitivity to light or sound
  • Nausea and vomiting
  • Difficulty doing physical activities like walking or climbing stairs

Some migraines have stages, various locations and escalate in severity. These migraines will have extra symptoms before and after the actual headache. Some of these extra symptoms are:

  • Numbness or a feeling of pins and needles in the arms, legs, fingers, or face
  • Problems with your vision
  • Trouble speaking
  • Weakness or difficulty moving your arms, legs, or face. This symptom is particularly rare.

How to Avoid the ER for Migraines

How do you avoid heading to the emergency room for a migraine? One way it to learn the most common migraine causes and cut those out of your daily lifestyle. Doctors are unsure of what causes migraines. But there are many environmental factors that can trigger a migraine.

Different people have different triggers, including:

  • Stress or anxiety
  • Changes in hormones (in women)
  • Bright lights, loud sounds, strong smells
  • Smoking
  • Drinking alcohol
  • Certain foods such as chocolate, cheese, salty foods, or processed foods
  • Food additives such as MSG
  • Insufficient eating
  • Insufficient sleep
  • Intense physical activity
  • Changes in the weather
  • Medicine

Treatment For Migraines

Now that you have some background on migraine headaches, let’s talk about migraine treatment.

You can treat migraines with over-the-counter medications like Tylenol and Advil. Your doctor can also prescribe stronger pain medications.

Doctors advise those who suffer from migraines to find their triggers and avoid them. There are also some medicines that prevent migraines from happening.

But these treatments don’t work for everyone. Some people have migraines so severe that typical medicines don’t touch them. What do those people do?

When Should I Go to the ER for a Migraine?

If your migraine is severe enough, it warrants a trip to the emergency room. If you go to the ER for migraines, you should have someone else drive you.

The symptoms of a migraine overlap with the symptoms of a stroke. You should go to the hospital right away if:

  • Your headache is unusually severe
  • You have speech, vision, movement, or balance problems, especially if these symptoms are new or unusual
  • You have a stiff neck or fever with your headache
  • The headache starts suddenly, especially if you are older than 50

Severe Migraine Treatment in the ER

If you are having a migraine and not some other medical emergency, your doctor will treat it with pain medications. An ER doctor will usually only offer mild pain killers or treat you for dehydration.

There are many medications that work together to relieve migraine pain. ER doctors and nurses administer these medicines intravenously, through the arm. Some of these medicines are:

  • Neuroleptics/antiemetics. These are medications that change the way chemicals act in your brain. They treat nausea and vomiting.
  • Sumatriptan. This is a headache medication that narrows the blood vessels in the brain. People with heart problems should not take this medicine.
  • NSAIDs. Non-steroidal anti-inflammatory drugs can relieve pain. These are usually over-the-counter. You can take them by mouth.
  • Opioids. Opioids relieve pain as well. But you should use these medications sparingly. They have serious side effects and can be addictive.
  • Dihydroergotamine. Like sumatriptan, this headache medication narrows the blood vessels in the brain.

Aside from medications that relieve, there are also medications that prevent your migraine from coming back.

The most thoroughly researched of these medications is dexamethasone, which treats swelling and inflammation. Doctors can give dexamethasone along with a pain reliever stop a migraine from returning.

There is not enough research into how well other medications work to stop a migraine from coming back.

What are the Side Effects of ER Migraine Treatment ?

The side effects of these migraine treatments are minor and temporary. The most common side effect is drowsiness, so you won’t be able to drive right away.

Each type of medicine has individual side effects as well. Some of these side effects are:

  • Neuroleptics/antiemetics. Restlessness in the legs or body is common. Very rarely, these medications can cause tics and tremors.
  • Sumatriptan. There may be pain or swelling at the site of the injection. Other side effects include redness in the face and neck, a burning feeling, feelings of tightness all over the body, and drowsiness.
  • NSAIDs. There are no typical side effects to these medications.
  • Opioids. Tiredness and drowsiness are common.
  • Dihydroergotamine. Similar to sumatriptan, there can be pain and swelling at the injection site. Drowsiness, stomach problems, and irregular heartbeat are also common.
  • Dexamethasone. Research has not found any definite side effects. However, possible side effects are nausea, dizziness, and trouble sleeping

Questions to Ask Your Doctor

At The Pain Relief Center, we want to provide the best service we can. Before your appointment, try to compile the following information:

  • Your history of severe migraines and history of ER migraine treatment
  • Any medicines you take regularly to treat your migraines
  • Which medicine works best for you
  • The possible benefits and side effects of the medicine

Questions we are frequently asked:

  • Which medicine we think might work best for you?
  • How fast the medicine will begin working?
  • How long the medicine will last?
  • The possible side effects?
  • How you can prevent migraines in the future?

Severe Migraine Treatment at The Migraine Institute

If you suffer from severe migraines and visit the ER, they will provide you with short term relief and long-term advice.

At The Migraine Institute, our pain specialists can help you find a long-term solution for your migraines that works for you. For more information, call 214.709.1904, or send us a message!


The most critical step on the path to recovery is finding a pain management doctor who can address your pain management needs successfully. The Pain Relief Center and its five specialized institutes are dedicated to meeting any and all of a patient’s needs. Located in the Dallas-Fort Worth area, Dr. Rodriguez and his friendly staff will help you along the path to recovery.

Our new center in Dallas is part of a nationwide development by Pain Relief Centers, geared to providing individualized and comprehensive healing and pain management services with unprecedented levels of compassion, care, and comfort for each patient.

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