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Status Migrainosus: Refractory Headache in a Woman with Pre-eclampsia

Grace Swain* , Natasha Gerbis, Georgina Davis

Headaches in pregnancy are common and carry a range of differential diagnoses. When faced with this diagnostic conundrum, it is important to consider and exclude sinister aetiologies such as pre-eclampsia and hemorrhagic stroke. A differential diagnosis of migraine is also warranted, given the high burden of migraine in young women. We report a case of refractory headache in a primiparous woman, resulting in an admission to the Intensive Care Unit (ICU), requiring multiple antihypertensive medications despite a negative preeclampsia screen. The woman was ultimately diagnosed with status migrainosus, resolving with the administration of a Chlorpromazine infusion. We highlight the difficulties involved in identifying and treating severe headaches in pregnant women.