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Migrain treatment in pregnancy

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https://www.readbyqxmd.com/read/28758416/pregnancy-outcome-after-anti-migraine-triptan-use-a-prospective-observational-cohort-study
#1
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
#2
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
#3
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...
June 24, 2017: 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
#4
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
#5
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
#6
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...
February 9, 2017: Headache
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#7
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
#8
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...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28101987/delivery-outcomes-of-patients-with-acute-migraine-in-pregnancy-a-retrospective-study
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27902848/topiramate-in-migraine-prevention-a-2016-perspective
#12
REVIEW
Stephen D Silberstein
BACKGROUND: In evidence-based guidelines published in 2000, topiramate was a third-tier migraine preventive with no scientific evidence of efficacy; recommendation for its use reflected consensus opinion and clinical experience. Its neurostabilizing activity, coupled with its favorable weight profile, made topiramate an attractive alternative to other migraine preventives that caused weight gain. When guidelines for migraine prevention in episodic migraine were published in 2012, topiramate was included as a first-line option based on double-blind, randomized controlled trials involving nearly 3000 patients...
January 2017: Headache
https://www.readbyqxmd.com/read/27818772/effectiveness-and-safety-of-an-extended-release-tablet-of-sodium-valproate-for-the-prophylactic-treatment-of-migraine-postmarketing-surveillance-in-japan
#13
Takao Takeshima, Norihiro Suzuki, Yasuhiko Matsumori, Naoki Shimmoto, Yuji Kurihara, Ryoji Gunji, Fumihiko Sakai
BACKGROUND: Sodium valproate is a standard drug for first-line prophylactic treatment of migraine. However, little information is available of its use in Japanese patients. AIM: To evaluate the effectiveness and safety of an extended-release tablet of sodium valproate in the prophylactic treatment for Japanese patients with migraine by postmarketing surveillance. METHODS: This was a prospective, multicenter and non-interventional observation study in routine clinical practice...
July 2016: Neurology and Clinical Neuroscience
https://www.readbyqxmd.com/read/27698740/neurological-teratogenic-effects-of-antiepileptic-drugs-during-pregnancy
#14
Qingmei Nie, Baohua Su, Jianping Wei
Epilepsy is one of the few neurologic disorders that requires a constant treatment during pregnancy. Epilepsy affects 0.3-0.8% of pregnant women. Prescription of antiepileptic drugs (AEDs) to pregnant women with epilepsy requires monitoring and maintaining a balance between limiting seizures and decreasing fetal exposure to the potential teratogenic effects. AEDs are also commonly used for psychiatric disorders, pain disorders, and migraines. The types of malformations that can result in fetuses exposed to AEDs include minor anomalies, major congenital malformations, intrauterine growth retardation, cognitive dysfunction, low IQ, microcephaly, and infant mortality...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27625061/longitudinal-changes-in-neurodevelopmental-outcomes-between-18-and-36%C3%A2-months-in-children-with-prenatal-triptan-exposure-findings-from-the-norwegian-mother-and-child-cohort-study
#15
Mollie E Wood, Jean A Frazier, Hedvig M E Nordeng, Kate L Lapane
OBJECTIVE: This study sought to determine whether changes in neurodevelopmental outcomes between 18 and 36 months of age were associated with prenatal exposure to triptan medications, a class of 5-HT receptor agonists used in the treatment of migraine. METHOD: Using data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort that includes nearly 40% of all pregnancies in Norway from 1999 to 2008, we identified 50 469 mother-child dyads who met inclusion criteria and were present for at least one follow-up assessment at 18 or 36 months postpartum...
September 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27624901/use-of-antimigraine-medications-and-information-needs-during-pregnancy-and-breastfeeding-a-cross-sectional-study-among-401-norwegian-women
#16
Siri Amundsen, Torunn G Øvrebø, Netta Marie S Amble, Anne Christine Poole, Hedvig Nordeng
PURPOSE: Migraine is highly prevalent among women of fertile age. The main objectives of this study were to describe the prevalence and patterns of use of antimigraine medications during pregnancy and breastfeeding and to identify maternal and migraine-related factors associated with medication use during pregnancy. METHODS: The study is a cross-sectional internet-based survey among pregnant women and new mothers with migraine conducted in Norway from October 1, 2013 to February 1, 2014...
December 2016: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27364828/dtb-select-7-july-2016
#17
(no author information available yet)
MHRA: avoid live vaccines in immunosuppressed patients ● Topical NSAIDs for musculoskeletal pain in adults ● Adherence to pregnancy prevention measures during isotretinoin treatment ● Impact of the NHS Health Check programme ● Ibuprofen: first choice for migraine in young people? ● Neuropsychiatric safety of ▼ varenicline and bupropion ● Effects of anticholinergic medication in cognitively normal older adults ● New NICE guidance for controlled drugs.
July 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27050859/recommendations-for-the-treatment-of-migraine-attacks-a-brazilian-consensus
#18
Carlos Alberto Bordini, Célia Roesler, Deusvenir de Souza Carvalho, Djacir Dantas P Macedo, Élcio Piovesan, Eliana Meire Melhado, Fabiola Dach, Fernando Kowacs, Hilton Mariano da Silva Júnior, Jano Alves de Souza, Jayme Antunes Maciel, João José de Freitas de Carvalho, José Geraldo Speciali, Liselotte Menke Barea, Luiz Paulo Queiroz, Marcelo Cedrinho Ciciarelli, Marcelo Moraes Valença, Márcia Maria Ferreira Lima, Maurice Borges Vincent
In this article, a group of experts in headache management of the Brazilian Headache Society developed through a consensus strategic measurements to treat a migraine attack in both the child and the adult. Particular emphasis was laid on the treatment of migraine in women, including at pregnancy, lactation and perimenstrual period.
March 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27002079/managing-migraine-during-pregnancy-and-lactation
#19
REVIEW
Rebecca Erwin Wells, Dana P Turner, Michelle Lee, Laura Bishop, Lauren Strauss
While over half of women with migraine report improvement during pregnancy, having a history of migraine may increase the chance of negative health outcomes. The state of pregnancy increases the risk of several dangerous secondary headache disorders, especially those associated with hypertensive disorders of pregnancy, and providers need to know the red flags to diagnose and treat emergently. Non-pharmacological migraine treatments can be instituted in advance of pregnancy as many are considered the safest options during pregnancy, but understanding the safety of medications and dietary supplements ensures appropriate care for the refractory migraine patient...
April 2016: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/26887532/a-critical-approach-to-evaluating-clinical-efficacy-adverse-events-and-drug-interactions-of-herbal-remedies
#20
REVIEW
Angelo A Izzo, Sung Hoon-Kim, Rajan Radhakrishnan, Elizabeth M Williamson
Systematic reviews and meta-analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta-analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy-induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause...
May 2016: Phytotherapy Research: PTR
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