We all love the lights, laughs, the gifts, and the music, but we don't love what the "holiday storm" (stress, disrupted sleep, travel, and maybe a little too much eggnog) can do to a sensitive nervous system.

For those of us living with chronic neurological conditions like migraine, epilepsy, etc., the holidays often come with a side of "Is this a flare-up, or is this an emergency?"

It can be scary to make that call when your neurologist’s office is closed for the long weekend. Here is your condition-inclusive guide to navigating the ER decision tree this season.

‍

When to go to the ER (Do not wait)

If you experience any of the following "red flag" symptoms, the Emergency Room is the safest place for you. These universal neurological signs often require immediate imaging or intervention that cannot be done at home or via video.

• A "thunderclap" headache: A sudden, severe headache that reaches maximum intensity in seconds or minutes (often described as "the worst headache of your life"), especially if it’s unlike your usual migraine pattern.
• Stroke signs (BE FAST): Sudden loss of balance, vision changes (like losing sight in one eye), facial drooping, arm/leg weakness (especially on one side), or slurred speech. Time is brain. So, go immediately.
• Seizure emergencies:
  • A seizure lasting longer than 5 minutes.
  • Cluster seizures (one after another) without regaining consciousness in between.
  • A seizure that occurs in water or results in injury.
• Head trauma: If you fall or hit your head and experience loss of consciousness, confusion, or vomiting.
• Fever + stiffness: High fever accompanied by a stiff neck and sensitivity to light (could indicate meningitis).
• Sudden, profound change: Sudden inability to walk, talk, or swallow, or sudden incontinence (loss of bladder/bowel control).

‍

When to wait (and message your care team)

Often, holiday symptoms feel urgent because they are miserable, but they may not require a trip to the ER. In these "grey area" moments, the ER might mean a 12-hour wait only to be given fluids and sent home.

Consider reaching out to your Neura Care Team or a neurology-focused urgent care if:

• It’s a "typical" flare-up: You are having a familiar flare that's more stubborn than usual due to holiday stress or weather changes.
• Medication side effects: You started a new med before the break and are feeling nauseous or dizzy (unless you have a severe allergic reaction, such as trouble breathing).
• The "holiday hangover": You missed a dose of medication, had a glass of wine, or stayed up too late, and now your symptoms are louder. Hydrate, rest, and resume your schedule.
• Gradual worsening: Symptoms that have been creeping up over weeks, like increased tingling or mild fatigue. This usually warrants an appointment, not an emergency visit.

‍

Your holiday defense plan

We know that 45% of Neura members reduce their ER visits after joining (because having a plan prevents panic).

1. Pre-game your meds: Ensure you have enough medication to last through New Year's now. Don't wait until the pharmacy closes early on Christmas Eve.
2. Protect your sleep: It is the single biggest shield for your brain. If you have to leave the party early to keep your seizure threshold safe or prevent a migraine attack, do it.
3. Hydrate: Champagne and salty appetizers can dehydrate you. Match every holiday drink with a glass of water.

‍

We are here for you

If you aren't sure if you need the ER, you don't have to guess alone.

Neura Health is staffed and able to help patients during the holiday season. We know neurological conditions don't pause for anything - not even pumpkin pie and candy canes.

Neura members have unlimited access to messaging the care team. We can help triage your symptoms, adjust your treatment plan, or call in a refill to a local pharmacy so you can get back to your celebrations sooner. Book a video visit with us.

Wishing you a low-pain, high-joy holiday season.

‍