American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is the most common complication of acute migraine?

1. Chronic migraine

2. Medication overuse headache

3. Status migrainosus

4. Cluster headaches

The correct answer is: Status migrainosus

The most common complication of acute migraine is status migrainosus. This condition is characterized by a debilitating migraine attack that lasts longer than 72 hours, often requiring medical intervention to alleviate the pain and associated symptoms. Status migrainosus can arise from a series of severe migraine attacks or as a progression of a singular migraine episode. The key factor here is the duration and severity of the migraine in this condition, which can significantly affect the quality of life and may lead to increased use of abortive treatments. When acute migraine episodes are not effectively treated, they may develop into status migrainosus, emphasizing the importance of prompt and effective management during the initial migraine attack. In contrast, while chronic migraine and medication overuse headache are significant concerns for individuals with a history of migraines, they are generally considered more of long-term complications rather than direct consequences of an acute migraine episode. Cluster headaches are distinct entities and do not typically emerge as a complication of acute migraine. Understanding these distinctions helps clarify why status migrainosus is viewed as the most common complication following an acute migraine.