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Migrain treatment in pregnancy

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https://www.readbyqxmd.com/read/29904828/estrogen-migraine-and-vascular-risk
#1
Gianni Allais, Giulia Chiarle, Silvia Sinigaglia, Gisella Airola, Paola Schiapparelli, Chiara Benedetto
Migraine has a predilection for female sex and the course of symptoms is influenced by life stage (presence of menstrual cycle, pregnancy, puerperium, menopause) and use of hormone therapy, such as hormonal contraception and hormone replacement therapy. Hormonal changes figure among common migraine triggers, especially sudden estrogen drop. Moreover, estrogens can modulate neuronal excitability, through serotonin, norepinephrine, dopamine, and endorphin regulation, and they interact with the vascular endothelium of the brain...
June 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29806076/does-the-anti-migraine-drug-rizatriptan-affect-early-neural-tube-development-in-chick-embryos
#2
Murat Sayin, Gülşen Seren Gürgen, Sevgi Sıdıka Sayin, Gönül Güvenç, Nurullah Yüceer
AIM: Migraine headaches are a common and significant issue experienced by women during pregnancy. However, treating migraines during pregnancy and post-pregnancy is challenging because of the risks that migraine medications pose to the fetus and infant. Few studies have investigated the effect of triptans during pregnancy, and controlled studies are not available. Our research aimed to investigate the impact of rizatriptan on neural tube development using early chick embryos as a model organism...
May 7, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29611008/characteristics-of-menstrual-versus-non-menstrual-migraine-during-pregnancy-a-longitudinal-population-based-study
#3
Beáta Éva Petrovski, Kjersti G Vetvik, Christofer Lundqvist, Malin Eberhard-Gran
BACKGROUND: Migraine is a common headache disorder that affects mostly women. In half of these, migraine is menstrually associated, and ranges from completely asymptomatic to frequent pain throughout pregnancy. METHODS: The aim of the study was to define the pattern (frequency, intensity, analgesics use) of migrainous headaches among women with and without menstural migraine (MM) during pregnancy, and define how hormonally-related factors affect its intensity. RESULTS: The analysis was based upon data from 280 women, 18...
April 2, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29563831/serotonin-receptor-agonists-in-the-acute-treatment-of-migraine-a-review-on-their-therapeutic-potential
#4
REVIEW
Andrea Negro, Angela Koverech, Paolo Martelletti
Migraine is an important socioeconomic burden and is ranked the sixth cause of years of life lost because of disability in the general population and the third cause of years of life lost in people younger than 50 years. The cornerstone of pharmacological treatment is represented by the acute therapy. The serotonin (5-hydroxytryptamine [5-HT]) receptor subtype 1B /1D agonists, called triptans, are nowadays the first-line acute therapy for patients who experience moderate-to-severe migraine attacks. Unfortunately, a high percentage of patients are not satisfied with this acute treatment, either for lack of response or side effects...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29310444/safety-of-galcanezumab-in-patients-with-episodic-migraine-a-randomized-placebo-controlled-dose-ranging-phase-2b-study
#5
Tina Marie Myers Oakes, Vladimir Skljarevski, Qi Zhang, William Kielbasa, Michael E Hodsdon, Holland C Detke, Angelo Camporeale, Joel R Saper
Background Safety findings from a Phase 2b study of galcanezumab, a humanized monoclonal antibody against calcitonin gene-related peptide, for prevention of migraine (NCT02163993) are reported here. Methods Patients aged 18-65 years with episodic migraine were evaluated in this multicenter, double-blind, randomized study. After randomization, 410 patients were administered 5, 50, 120 or 300 mg of galcanezumab or placebo subcutaneously once every 4 weeks for 12 weeks, followed by a post-treatment off-drug period lasting 12 weeks...
May 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29225682/frontal-lobe-meningioma-mimicking-preeclampsia-a-case-study
#6
Jinny Y Foo, Gregory K Davis, Mark A Brown
We report a case of a left frontal lobe meningioma presenting in a woman with proteinuric preeclampsia in her first term pregnancy. The patient had a background of antepartum migraines that resolved in the second trimester of pregnancy. Postpartum, she required urgent surgery and sustained convulsions after surgery. She had no residual disease and has had another successful pregnancy. This case highlights the importance of cerebral imaging in the context of an atypical clinical course of preeclampsia. Although headaches are common in pregnancy and usually benign, other, more serious, diagnoses should be considered with atypical headaches, a change in the nature of the headache, and headaches that persist despite appropriate treatment...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29052046/headache-and-pregnancy-a-systematic-review
#7
REVIEW
A Negro, Z Delaruelle, T A Ivanova, S Khan, R Ornello, B Raffaelli, A Terrin, U Reuter, D D Mitsikostas
This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome...
October 19, 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28980122/migraine-treatment-in-pregnancy-and-lactation
#8
REVIEW
Anne H Calhoun
PURPOSE OF REVIEW: Since up to 40.9% of reproductive aged women have migraine-and reproductive-aged women often reproduce-it is essential that we have good information and guidelines regarding proper treatment of migraine during pregnancy and lactation. RECENT FINDINGS: A review of articles published in the last year on the treatment of migraine during pregnancy and lactation found dishearteningly little. Nevertheless, this article will review the risk/safety information related to migraine treatment in both pregnancy and lactation, citing both new and less recent publications...
October 4, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28974300/the-treatment-of-illnesses-arising-in-pregnancy
#9
Michael Bolz, Sabine Körber, Toralf Reimer, Johannes Buchmann, Hans-Christof Schober, Volker Briese
BACKGROUND: The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS: We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri cians and Gynecologists, and the Royal College of Obstetricians and Gynaecologists) over the period 2007-2016 for information on standards for the diagnosis and treatment of five illnesses that can arise in pregnancy: bronchial asthma, migraine, hypothyroidism, hyperthyroidism, and varicose veins...
September 15, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28758416/pregnancy-outcome-after-anti-migraine-triptan-use-a-prospective-observational-cohort-study
#10
Kevin Spielmann, Angela Kayser, Evelin Beck, Reinhard Meister, Christof Schaefer
Objective The objective of our study is to assess the impact of triptan exposure on pregnancy outcome. Methods We performed a prospective observational cohort study with 432 pregnant women exposed to triptans and enrolled by the German Embryotox system. Pregnancy outcomes were compared with a migraine and a non-migraine comparison cohort. Primary objectives were major birth defects and spontaneous abortion; secondary endpoints were preterm delivery, birth weight, pregnancy complications and the rate of electively terminated pregnancies...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28752512/medical-treatment-guidelines-for-preventive-treatment-of-migraine
#11
Tzu-Chou Huang, Tzu-Hsien Lai, Treatment Guideline Subcommittee Of Taiwan Headache Society Taiwan Headache Society
The Treatment Guideline Subcommittee of the Taiwan Headache Society evaluated the medications currently used for migraine prevention in Taiwan. We assessed the results of new published drug trials, information from medical database and referred to the latest guidelines published. After comprehensive discussion, we proposed Taiwanese consensus about the preventive treatment for migraine including recommendation levels, strength of evidences, and related prescription information regarding dosage and adverse effects...
March 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#12
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g., premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
January 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28561915/migraines-in-women-current-evidence-for-management-of-episodic-and-chronic-migraines
#13
REVIEW
Angela Deneris, Peggy Rosati Allen, Emily Hart Hayes, Gwen Latendresse
Migraine headache is a disabling brain disorder that affects millions of women in the United States. Many migraine sufferers are undertreated. Both inadequate treatment and overuse of abortive migraine medication can contribute to progression from episodic to chronic migraine disorders. A significant number of migraine headaches or severity of episodic migraine headaches warrants treatment with prophylactic medications for prevention. This clinical update reviews the pathophysiology and diagnosis of migraine headaches in women, discusses the efficacy of abortive and chronic pharmacologic treatment, and examines strategies to prevent progression from episodic migraine to chronic migraine...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28240610/calcitonin-gene-related-peptide-monoclonal-antibodies-for-migraine-prevention-comparisons-across-randomized-controlled-studies
#14
REVIEW
Dimos D Mitsikostas, Uwe Reuter
PURPOSE OF REVIEW: The results of phase 2 randomized controlled trials for the prevention of episodic and chronic migraine demonstrating the efficacy and safety of four mAbs targeting the calcitonin gene-related peptide (CGRP) pathway [ALD403 (eptinezumab), AMG334 (erenumab), LY2951742 (galcanezumab) and TEV48125 (fremanezumab)] have been published recently, and phase 3 trials are in process. This development will change headache management fundamentally. We aim to summarize and compare the phase 2 data...
June 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28181217/hypercoagulability-and-migraine
#15
Gretchen E Tietjen, Stuart A Collins
BACKGROUND: A growing body of literature suggests that migraineurs, particularly those with aura, have an increased risk for ischemic stroke, but not via enhanced atherosclerosis. The theory that micro-emboli induced ischemia provokes cortical spreading depression (ie, symptomatic aura) in migraineurs but transient ischemic attacks in others highlights a potential role for hypercoagulability as a link between migraine (with aura) and stroke. AIM: Our objective is to summarize the literature evaluating the association of migraine with various acquired or inheritable thrombophilic states, including those related to elevated estrogen levels, endothelial activation and dysfunction, antiphospholipid antibodies (aPL), deficiency of coagulation inhibitors, and presence of certain genetic polymorphisms...
January 2018: Headache
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#16
REVIEW
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28145727/estrogen-dependent-effects-of-5-hydroxytryptophan-on-cortical-spreading-depression-in-rat-modelling-the-serotonin-ovarian-hormone-interaction-in-migraine-aura
#17
Virginie Chauvel, Sylvie Multon, Jean Schoenen
Background Cortical spreading depression (CSD) is the likely culprit of the migraine aura. Migraine is sexually dimorphic and thought to be a "low 5-HT" condition. We sought to decipher the interrelation between serotonin, ovarian hormones and cortical excitability in a model of migraine aura. Methods Occipital KCl-induced CSDs were recorded for one hour at parieto-occipital and frontal levels in adult male (n = 16) and female rats (n = 64) one hour after intraperitoneal (i.p.) injection of 5-hydroxytryptophan (5-HTP) or NaCl...
March 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28101987/delivery-outcomes-of-patients-with-acute-migraine-in-pregnancy-a-retrospective-study
#18
Tracy B Grossman, Matthew S Robbins, Shravya Govindappagari, Ashlesha K Dayal
OBJECTIVE: To describe labor and delivery outcomes in pregnant patients presenting to the hospital setting with an acute severe migraine headache attack earlier in the same gestation. METHODS: We retrospectively reviewed pregnancy and delivery records from a database of consecutive inpatient neurology consultations for acute headache in pregnant women over a 5 year period. RESULTS: We identified 86 pregnant women with acute migraine. The mean age was 29...
April 2017: Headache
https://www.readbyqxmd.com/read/27999514/hemorrhagic-stroke-resulting-from-venous-malformation-at-20-weeks-of-pregnancy
#19
Nicole D Ulrich, Elizabeth R Lapeyre, Robert C Moore
BACKGROUND: Stroke in the pregnant patient is not a common occurrence. Despite its relative rarity, stroke during pregnancy is associated with high morbidity and mortality for both mother and infant. We report the case of a patient who experienced a hemorrhagic stroke during pregnancy because of venous cavernoma. CASE REPORT: A 34-year-old patient, gravida 5 para 1-0-3-1, presented to labor and delivery triage at 21 weeks, 0 days' gestation with the concern of sudden-onset right-sided facial, arm, and leg numbness and weakness...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27966404/-ischemic-stroke-in-young-women
#20
REVIEW
M S Ekker, M J H Wermer, N P Riksen, C J M Klijn, F E de Leeuw
- In virtually all age groups, the incidence of ischemic stroke is higher in men. However, in women aged between 25-49 years the prevalence is higher than in men. Female-specific risk factors and disorders may explain this peak.- Pregnancy and the post-partum period are associated with physiological changes which can increase blood coagulation. Complications during pregnancy may also increase the risk of ischaemic stroke.- Migraine with aura and antiphospholipid syndrome are disorders which are also associated with an increased risk of ischaemic stroke...
2016: Nederlands Tijdschrift Voor Geneeskunde
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