What is your preferred approach to a pregnant patient in status migrainosus refractory to first line treatments?   

I bring these patients in for occipital nerve blocks with only 2% Lidocaine. This is safe in pregnancy and has a high rate of success.

I have used high-intensity oxygen 6L via nasal cannula for 15 minutes every 6 hourly for 2-3 days along with 1 gm IV Magnesium for a day or two and +/- Fioricet. This cocktail helps about 60-80%. If the patient continues to show no improvement, then one has to make sure you are not dealing with pree...