Migraine
What is migraine headache?
Migraine headache is a type of headache which occurs due to blood vessels dilating in the brain. Some women with migraine may experience all or some of the symptoms below:
- Moderate to severe throbbing or pounding pain which could affect the whole head or only one side
- Sensitivity to light and noise
- Blurring of vision, tunnel vision or blind spots
- Nausea , vomiting or stomach upset
- Fatigue and dizziness
- Fever (rare)
- Aura symptoms such as experiencing seeing bright flashing dots, lights, jagged or wavy lines
I suffer from migraine and I plan to get pregnant. What should I do about my migraine? Will it get worst?
About 60-70% of women with migraine will improve and be symptoms free during pregnancy. 1 No more than 10% will deteriorate during pregnancy. However, as many as 1 in 10 women will experience their first migraine attack during pregnancy which usually occurs during the first trimester. It appears that migraine is affected by the fluctuating levels of estrogen where in condition such as post delivery and menses, the migraine is worse due to the low levels of oestrogen. On the other hand, during pregnancy where there is high level of oestrogen migraine headache improves.2
If you are planning to get pregnant, you may want to speak to your doctor regarding changing your migraine treatment regime as some of them are not suitable during pregnancy. However, if you suffer from frequent migraine, you may want to plan a treatment plan to prevent your migraine which is relatively safe during pregnancy. Do not worry a history of migraine will not affect your baby or the outcome of your pregnancy.
How could I prevent my migraine headache during pregnancy?
Try to avoid possible triggers of migraine headache:
- Stress
- Chocolate
- Banana
- Cheese
- Coffee
- Changes in your sleeping or eating habits
- Try to avoid low blood sugar by eating complex carbohydrates and having frequent smaller meals
Keep a migraine diary to note down anything that triggers your migraine attack.
What could I do when I get my migraine attack?
- Take a panadol
- Apply ice pack to your head
- Lie down in a quiet, dark room to avoid further aggravating your migraine
- Have a cold shower
- Relaxation technique such as mediation or yoga
What is the treatment for my migraine headache during pregnancy?
- Panadol is the first line and safe to use during pregnancy
- Codeine based analgesia may be prescribed by your doctor if the headache is too severe
- Anti nausea medication such as metoclopromide could be given as well
- Sumatriptan is an effective medication for migraine. It is a serotonin antagonist that causes constriction of the blood vessels in the brain. Hence, theoretically it could interfere with blood flow through the placenta leading to growth restriction.3 Human experience with usage of sumatriptan during pregnancy has been reassuring. However, it should be avoided if possible and only used if other medication fails.
- You should avoid ergotamine during pregnancy.
When should I see my doctor regarding my migraine headache?
- If the headache is persistent, last several hours or severe
- If the headache is different compared to your usual headache
- If your also have fever or blurring of vision
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REFERENCES
1. Silbersten SD. Headaches in pregnancy. Neuro Clinic. Nov 2004; 22(4):727-56
2. Marcus DA. Interrelationships of neurochemicals, estrogen and recurring headache. Pain 1995 Aug; 62(2):129-39
3. Olesen C, Steffensen FH, Sorensen HT et al. Pregnancy outcome following prescription for sumatriptan. Headache 2000 Jan; 40(1):20-24.
