Course of migraine during pregnancy among migraine sufferers before pregnancy

Abstract

Objective: To describe the course of migraine without aura and migraine with aura during pregnancy and factors that could influence its course, among migraine sufferers before pregnancy. Method: A cross sectional study undertaken at the IMIP, Brazil. Out of 686 consecutively assisted women, at the first postnatal week, 266 were identified as migraine sufferers before pregnancy. Results: There was migraine remission in 35.4%, 76.8% and 79.3% among migraine without aura sufferers and 20.7%, 58.6% and 65.5% among those with migraine with aura, respectively in the first, second and third trimesters. Statistically significant difference was found when the first trimester was compared with the second and third trimesters. The factors associated with the presence of migraine during pregnancy were: multiparity, menstrually related migraine without aura prior to pregnancy and illness during pregnancy. Conclusion: The study contributed to elucidate the course of migraine during pregnancy in migraine sufferers prior to pregnancy. Key words: migraine without aura, migraine with aura, pregnancy.Comportamento da enxaqueca durante a gestação em mulheres portadoras de enxaqueca pré-gestacional RESUMO Objetivo: Descrever o comportamento da enxaqueca com e sem aura durante a gestação e fatores que possam influenciar o seu curso, em mulheres com enxaqueca antes da gestação. Método: Estudo transversal realizado no IMIP, Brasil. De 686 mulheres consecutivamente assistidas na primeira semana pós-parto, 266 foram identificadas como portadoras de enxaqueca antes da gestação. Resultados: Houve desaparecimento das crises de enxaqueca, tanto na enxaqueca sem aura em 35,4%, 76,8% e 79,3%, como na enxaqueca com aura em 20,7%, 58,6% e 65,5%, respectivamente no primeiro, segundo e terceiro trimestres de gestação, com diferença estatisticamente significante quando se comparou o primeiro, com o segundo e terceiro trimestres. Os fatores associados à presença de crises de enxaqueca foram: multiparidade, enxaqueca sem aura relacionada à menstruação antes de gestação e doença durante a gestação. Conclusão: O estudo contribuiu para elucidar o comportamento da enxaqueca durante a gestação em mulheres com enxaqueca antes da gestação. Palavras-chave: enxaqueca sem aura, enxaqueca com aura, gravidez.

The Association of Migraine with Menstrually Related Mood Disorders and Childhood Sexual Abuse

“…[2][3][4][5] It is widely accepted that the sudden withdrawal of estrogen can trigger some attacks of migraine without aura (MO). [6][7][8][9] In contrast to MO, MA is thought to be associated with higher concentrations of estrogen, consistent with the finding that the suppression of endogenous estrogen production reduces the frequency of auras in migraineurs. 8,10,11 Estrogens are also implicated in cortical spreading depression, an electrophysiological phenomenon of cortical excitation followed by inhibition that is considered to be an underlying biological mechanism of the aura phase of migraine.…”

Association Between Migraine and Diabetes in Pregnancy

“…This could be attributed to stable levels of estrogen and progesterone, along with an increase in beta-endorphin. Beta endorphin is known for its anti-nociceptive effect during pregnancy, which might be a possible reason for the changing course of migraine during pregnancy (18,19). An interesting finding in this study was that the prevalence of migraine attacks without aura was high in the study subjects and did not subside during pregnancy.…”

Headache Research and Medical Practice in Brazil: An Historical Overview

“…Comparing with the normal weight group (32%), the prevalence was higher in overweight children (39%; odds ratio [OR] 1.35, 95% confidence interval [CI] 0.51‐3.61) and even higher in the obese group (52%; OR 2.25, 95% CI 0.99‐5.12). Metabolic syndrome was found in 25%, and patients with the syndrome did not have higher prevalence of headache (52% vs 45%); (3) In adults, the metabolic syndrome does not appear to influence headache prevalence in obese patients; (4) A score to differentiate migraine from tension‐type headache was established, using 536 headache attacks reported by 121 nurses during a 2‐month follow‐up; (5) 14 new cases of corpalgia in migraine patients were described; (6) The continuous prophylactic use of propranolol, amitryptiline, or simvastatin in migraineurs decreases both the frequency of headache attacks and the production of nitric oxide in the blood; (7) Vitamin B6 has a preventive effect on menstrual migraine when used at a dose of 600 mg/day from the 14th day until menstruation; (8) Clinical symptomatology of the postdural puncture headache and risk factors were evaluated in 640 raquianesthesias; (9) Melatonin‐induced analgesia in addition to inhibiting neoplasic growth using a mouse or rat as the animal model; (10) The history of primary headache is a risk factor of headache related to hemodialysis (52% vs 12%); (11) A descriptive, comparative, cross‐sectional study with 110 postmenopausal women (recent [<5 years] vs late [≥5 years]) showed that the recent postmenopausal group presented highest average scores in the memory/concentration, vasomotor symptoms, and attractiveness domains in the Women's Health Questionnaire for assessment of their quality of life; (12) Prior history of headache is a risk factor of postmastectomy pain (OR 1.92; 95% CI: 1.10‐3.34); (13) Sentinel headache, as warning sign of subarachnoid hemorrhage due to ruptured intracranial aneurysm, was present in 18% of the patients; (14) The characteristics of head pain in response to an experimental cold stimulus to the palate in 414 volunteers were described; (15) Chronic posttraumatic headache after mild traumatic brain injury is similar to migraine in women; (16) There was migraine remission in 35%, 77%, 79%, respectively, in the first, second, and third trimesters among migraine without aura sufferers during pregnancy, and exclusive breastfeeding was associated with a lower chance of migraine recurrence at the first postpartum month; (17) Perfumes, paints, gasoline, and bleach are the most frequent odorants that trigger migraine attacks; Osmophobia predominated in patients with migraine and may be a specific maker to differentiate migraine from tension‐type headache; (18) In a population of 726 children and adolescents, headache was significantly associated with myopia (OR 2.67), hyperopia (OR 3.10), astigmatism (1.86), and strabismus (5.21); (19) Water deprivation is associated with increase of pain in the head in rats; (20) In a study involving 417 university students, 53% of them mentioned they ha...…”

“…Another important journal containing articles on headache written by Brazilians is Arquivos de Neuropsiquiatria, which was founded in 1945. 18,19,21,23,[41][42][43]52,81,[107][108][109][110]129,132,138,139,141,[147][148][149]153,158,[171][172][173] The Brazilian Headache Society created its own journal in 1983, entitled Migraneas & Cefaleias (ISSN1678-6270). In 2011, the Society decided to upgrade the journal in an attempt to enable it to become a truly international publication, accepting papers in English as well as in Portuguese.…”