Migraines can usually be managed with prescription medications that you can take on your own. But if you have a migraine that persists for days or is associated with neurological symptoms such as vision loss or motor weakness, you need to get medical attention. When you have this type of severe migraine attack, you may be on the fence between going to the emergency room, going to urgent care, calling your healthcare provider, and waiting for your symptoms to get better.
Here are some tips to help you recognize a migraine emergency and decide what to do.
Verywell / James Bee
When a Migraine Is an Emergency
There are several types of migraine emergency, all of which can be overwhelming. A migraine emergency usually feels different from a regular migraine, and your symptoms may feel unfamiliar and confusing. Migraine emergencies include:
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Overall, it is not a good idea to ignore unusual migraine symptoms. While there is a strong chance that you may not be experiencing a serious medical event, it is best to have a professional medical evaluation.
ER vs. Urgent Care
If you don’t know what to do about your symptoms, you have a few choices. You might call your healthcare provider’s office to ask for advice. But if you need immediate medical care, keep in mind that your healthcare provider’s office is not equipped to give you the kind of medical attention you may receive at an urgent care clinic or in theemergency room.
Once you are seen in urgent care or in the ER, the medical staff will evaluate you and take action to medically stabilize you as needed. If you need to be transferred to a setting with facilities that can handle more serious medical issues, then you will remain under medical care throughout that process. Do not stress too much about making the “right” choice—just get medical attention as promptly as possible.
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Often, when symptoms are concerning, unusual, or severe, going to the urgent care or emergency room is the best thing to do.
Similarities
There are similarities between urgent care and emergency room approaches to migraine.
Type of care: Urgent care and emergency rooms are both prepared to administer treatments such as intravenous (IV) fluids andantiemetics, and to closely monitor your vital signs.
Triage: When you go to seek medical help in urgent care or an emergency room, the amount of time that you have to wait depends on the urgency of your situation more so than factors such as whether you called ahead. If your condition is not deemed urgent and you are out of network, then you may be given the option to leave at this time, rather than incurring a high out-of-pocket cost.
Hospitalization: The healthcare providers in the emergency room and in the urgent care will be able to determine whether you need to be admitted to the hospital. Staff in either setting can begin to coordinate the arrangements for your admission.
Payment:Most health plans have clear policies about coverage for urgent care and emergency room visits, including your shared cost or copay amounts, and will provide you with details regarding which locations are in your network.
If you have to pay for your emergency room or urgent care services out-of-pocket, then it is much more difficult to estimate the cost ahead of time because it will include the cost of the healthcare practitioner orextended care providerevaluation, nursing care, IV fluids, medications, diagnostic tests, and the cost of using the bed itself. The overall cost to you can add up in the tens of thousands within a few hours.
Costs and Features of Emergency Room and Urgent Care
Differences
When you have a migraine emergency, differences between urgent care and emergency room care include:
Transportation: If you can’t drive, have fallen, have hadconvulsions, are showing a decreased level of consciousness, or have weakness in one side of your body, you need an ambulance to transport you. An ambulance will take you to the emergency room, not to urgent care.
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Waiting time: While this isn’t a hard-and-fast rule, urgent care tends to be less crowded, and the patients there are not usually as sick as patients in the emergency room. This often results in shorter waiting times, because the patients ahead of you are not likely to have a major medical crisis (such as a car accident) and they are usually discharged faster than patients in the emergency room.
Noise level: In general, emergency rooms, and even emergency room waiting areas, are louder than urgent care settings. The sound of ambulances arriving, overhead emergency announcements, and patients being transported for procedures can be disruptive if you have a migraine.
Imaging:Computerized tomography (CT) scansandmagnetic resonance imaging (MRI)are usually available in the emergency room rather than in urgent care, even though exceptions to this exist.
Deciding where to go for medical attention can be tricky. If you are having nausea and vomiting, or if your migraine is lasting for days, then you do not need to go to an emergency room and you can get the help you need at urgent care. However, if you have a fever, stiff neck, or neurological symptoms such as weakness, speech difficulty, or convulsions, then you need to be seen in an emergency room.
A Word From Verywell
The best way to avoid a migraine that prompts you to seek urgent care or emergency care is to use preventive strategies, including avoidance of triggers, talking to your healthcare provider about whether you need prophylactic medication, and learning aboutmedication overuse headaches.
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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Headache.
American Migraine Foundation.Thunderclap headaches.
Centers for Disease Control and Prevention.Meningococcal disease symptoms and complications.
Lee MJ, Lee C, Chung CS.The migraine-stroke connection.J Stroke. 2016;18(2):146-156. doi:10.5853/jos.2015.01683
Zodda D, Procopio G, Gupta A.Evaluation and management of life-threatening headaches in the emergency department.Emerg Med Pract.2019;21(2):1-20.
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