Migraine in pregnancy

The authors analyze migraine types, diagnostics and examinations with different treatment possibilities in pregnant migraineurs. The study is based on the team's own medical outpatients ward practice from 1990 to 2006, involving a total of 288 investigated migraineurs, 26 of whom were treated during pregnancy. The aim of the work was to ascertain the occurrence, type and characteristics of migrainous attacks during the pregnancy migraineurs including those in whom the first attack took place during pregnancy. All patients were investigated on a regular basis by neurologists, by EEG and 1.5T magnetic resonance. Migraine without aura in our patients' group affected 88.46% of persons, while 7.68% of persons suffered from migraine with aura, retinal migraine was present in 1 person. A visual aura was most frequent in cases of migraine with aura. Results: Newly occurring attacks always appeared in 1st trimester. Frequency, intensity and duration of attacks improved significantly already in 1st trimester in 13% of migraineurs. In 7 % of persons, attacks did not occur during pregnancy. Only patients whose migraines were associated with menstruation experienced a reduction or the total disappearance of attacks. 53 % of pregant migraineurs experienced improvement in the 2nd trimester, 28 % of the patients experienced further improvement in the 3rd trimester. Frequency of attacks increased after delivery in the case 45% of migraineurs. Conclusion: Patients whose migraines were associated with menstruation or menarche experienced significant reductions in attacks during pregnancy. Maximum migraine frequency in pregnant migraineurs appears in 1 st trimester. Pregnancy has favourable influence on migraine predominantly in 2nd and 3rd trimesters (in up to 81 % persons). Treatment is aimed at the elimination of migraine trigger factors and non-pharmacological treatment. Pharmacological treatment of pregnant migraineurs is possible and is described in this article.