Migraine during pregnancy, early treatment

11.02.2016
Maltseva Marina Arnoldovna

Head of the consultation department - neurologist, specialist in the field of extrapyramidal pathologies, doctor of the highest category

Migraine during pregnancy can occur even in women who have not previously suffered from this disease. About 25% of expectant mothers experience migraine with aura. It is difficult to even imagine how difficult it is for pregnant women to endure the terrible symptoms of migraine, since their body is already in critical condition. If you can no longer endure the pain, you should find a way out that would not harm either the pregnant woman or the baby.

Migraine during pregnancy

Migraine is a hereditary disease that is expressed as a sharp pain sensation. The headaches are unbearably strong, they are too tough for ordinary pills, such as No-Shpa, Paracetamol, etc. Migraine in pregnant women is accompanied by certain factors called “auras”. This:

• Fearful attitude towards light.
• Intolerance to strong smells and loud sounds.
• Closed state.
• Unbearable nausea and even vomiting.

Very often, pregnant women accept all these symptoms as a normal malaise, and use Citramon, or apply a cool compress.

Why do pregnant women get migraines?

Each organism has its own reasons for this or that process, but there are common reasons why unbearable headaches appear during pregnancy. These include:

• Eating too much chocolate, cheese or citrus fruits.
• Insufficient amount of water in the female body.
• Significant overdose of drugs.
• Constant lack of sleep, worries and stress.
• The body's reaction to the weather outside the window.
• Significant weight gain.
• Use of hormonal drugs.
• Violations of the general regime.
• Hypothermia or, conversely, overheating of the body.

“Migraine during pregnancy, what to do?” – the answer to this question may also be taking a cold shower. The water temperature should be about 21-26 degrees, but being under water should not be longer than 5 minutes.

Types and symptoms of migraine auras

Let's look at the main types of auras and how they manifest themselves.

Visual or ophthalmological

This aura is called “classical”. With it, visual images appear - flashes of light, curved or straight lines, flickering objects, white or golden figures, spherical images, etc.

Symptoms develop over 5-30 minutes. Positive ones can be replaced by negative ones. The duration of the aura can reach 1 hour. The image usually appears in the center of the visual field. It gradually increases and moves to the periphery. A scotoma remains behind him

– dark, “blind” area. During the aura or within an hour after its appearance, pain occurs. When the attack ends, any disturbances go away without consequences.

Retinal

With such an aura, scotomas or blindness in one eye occur. Symptoms persist for up to 1 hour. The headache comes after scotomas in about an hour, but can also occur before them. This is a rare type of aura. There is an assumption that the symptoms appear due to spasm of the central retinal artery. In most patients, retinal migraine attacks alternate with migraine attacks with or without classic aura.

Auditory

Auditory auras are hallucinations with sound. Ringing in the ears may occur, and patients sometimes hear music or voices. Doctors associate this aura with epileptic activity in the cerebral cortex, in its temporal region.

Speech

It manifests itself as a speech disorder because it affects the speech centers of the brain. Before an attack of pain, for a few minutes, no more, it is difficult or impossible for a person to speak. He can rearrange syllables in words, letters, repeat the same thing. At the same time, the consciousness is absolutely pure.

Vestibular

This is an aura in the form of movement disorders - dizziness. A fairly common phenomenon that can be hidden or obvious. In the second case, a person “sicks” even with small loads. In the first, violations can only be detected within the framework of an examination. According to the ICD, 2 forms of vestibular migraine are distinguished:

• Basilar
  - occurs rarely, mainly in teenage girls. The attack begins with visual disturbances, followed by dizziness, tinnitus, sensory disturbances, etc. Then, in 25% of cases, confusion occurs. Neurological symptoms persist for 20-30 minutes, then pain in the back of the head occurs. Without treatment, throbbing pain may persist for 2-3 days.
• Paroxysmal dizziness of younger children
  (benign). Occurs in children 1-4 years old. It manifests itself as short – from a few seconds to a few minutes – attacks of dizziness. The child loses stability, becomes anxious, and vomits. He may turn pale and sweat profusely. No headache. Attacks may recur over several months or years.

Vegetative

Often such auras are manifested by a feeling of heat, chills, cold, trembling; the face and neck may turn red or pale. Goosebumps may appear, and hairs may even rise on the skin. During an attack, the size of the pupil may change, and asymmetrically. Usually such an attack is part of a complex attack, and not an independent phenomenon.

Migraine during pregnancy. How to treat?

Anti-migraine medications should be used with great caution and only after consulting a doctor. During pregnancy, a woman's body can react differently to one drug or another, so you need to be extremely careful about what you take. Only qualified doctors can determine what is possible for migraines during pregnancy, since they have the necessary knowledge and practice.

Having figured out what kind of phenomenon migraine is in pregnant women and how to treat it, a few words need to be said about prevention. It is best to build a daily routine and stick to it, yoga for pregnant women will not harm anyone to keep your body in good physical condition. A head and neck massage will be helpful, and most importantly, eat what your body requires and drink plenty of water.

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Possible causes of headaches during pregnancy

Headaches occur in more than a third of women during pregnancy; most patients have not previously complained of such symptoms. If discomfort occurs against the background of fatigue and toxicosis, it will pass simultaneously with other clinical signs. Of particular danger are cases in which headaches occur simultaneously with nausea and vomiting, surges in blood pressure, decreased visual acuity, and even fainting. All these factors should be a reason to consult a doctor, as they can affect the normal development of the fetus.

The causes of headaches in pregnant women may vary. Doctors at the Clinical Brain Institute will be able to preliminarily determine them during the initial examination. To do this, you will need information about the conditions under which pain occurs, its duration, nature and location, as well as the conditions for its disappearance. The most common cause is migraine. This term refers to acute, throbbing pain that occurs suddenly and spreads to half or the entire surface of the head. It is accompanied by nausea, dizziness, disorders of the gastrointestinal tract and visual apparatus. Predisposing factors to its occurrence may be:

• sudden changes in temperature and humidity, weather changes;
• nervous tension, stressful situations;
• chronic fatigue, lack of normal sleep and wakefulness;
• prolonged exposure to trigger factors, including bright lights or loud sounds.

Another type is tension headache (TTH) . This is a condition that is characterized by local painful sensations that begin in the occipital or frontal lobes and then spread to the entire surface of the head. They can be of varying intensity, but do not cause nausea - this is their main difference from migraines. They are often caused by emotional tension and stress, as well as excessive physical or mental stress. The pain in most cases occurs after waking up and gradually intensifies during the day. Its duration ranges from 30 minutes to several days, but it is easily relieved with painkillers.

Cluster headaches (CHH) are a separate type. They appear when you feel well, for no apparent reason, and can last from 15-20 minutes to an hour. They are sharp, pulsating, localized at a certain point and do not spread to the entire surface of the head. Their characteristic feature is periodicity. Such pain can occur several times a day or a week, but at regular intervals.

Headaches during pregnancy are also associated with the following conditions:

• hormonal disorders and natural changes;
• diseases associated with surges in blood pressure;
• toxicosis of pregnant women and associated dehydration;
• unhealthy diet with a predominance of fatty or sweet foods, as well as an insufficiently nutritious diet;
• increased air pollution, prolonged stay in a stuffy room.

Headaches can also be symptoms of old chronic diseases that worsen during pregnancy. Hypo- or hypertension, changes in intracranial pressure, vascular pathologies - all these problems can manifest themselves as the body experiences significant stress. It is also worth understanding that old cranial herbs, which have long ceased to bother the patient, can cause headaches during pregnancy.

In the first trimester

Headaches in the first trimester of pregnancy are common. Significant changes occur in a woman’s body, to which she has yet to adapt. Among the reasons that can cause headaches in early pregnancy are:

• an increase in the total volume of blood in the vessels - it creates additional pressure and causes stretching of the vascular walls;
• increased concentrations of hormones (estrogens, progesterone), which can cause fluctuations in vascular tone;
• correction of lifestyle and nutrition, giving up certain foods and bad habits - these changes also require a period of adaptation;
• early toxicosis is a reaction of immune mechanisms to the fetus.

Early toxicosis is considered to occur before 12-13 weeks. During this period, pregnancy often proceeds without clinical manifestations, but some women complain of headache, nausea and general weakness. This reaction is caused by the immune system's response to the formation of the fetus. Normally, some mechanisms are blocked that perceive it as a foreign protein, but this process can also be accompanied by headaches and discomfort.

In the second trimester

The second trimester of pregnancy is a less dangerous period. Some women still complain of toxicosis and other side effects, but, in general, the adaptation mechanisms are already sufficiently formed. If headaches begin to occur during this period, you should pay attention to your well-being - a symptom may signal dangerous disorders. These include:

• glaucoma is a group of diseases in which there is an increase in intraocular pressure;
• sinusitis - inflammatory processes in the paranasal sinuses;
• inflammation of the brain and its membranes;
• osteochondrosis of the cervical spine is a disease that is manifested by a decrease in metabolic processes in hyaline cartilage and its gradual destruction, which leads to compression of nerves and blood vessels;
• diseases of the kidneys and urinary system are the cause of the accumulation of excess fluid in the body.

Not every headache should be a cause for concern. If discomfort continues for 5 days or more, accompanied by decreased visual acuity or stiffness of the neck muscles, you should immediately consult a doctor. In other cases, the symptom may be the result of overwork or physical stress, or lack of daily routine.

In the last trimester

In the last trimester of pregnancy, headaches can develop for several reasons, including physiological ones. An increase in body weight leads to increased curvature of the spinal column. This condition increases the risk of compression of the blood vessels that carry oxygenated blood to the brain. The result of this condition is tissue hypoxia, which is manifested by a deterioration in general health and headache. In addition, a decrease in physical activity also causes poor blood circulation. Even in the third trimester, it is worth paying attention to light physical activity.

In some cases, headaches are caused by nervous tension and stress associated with the upcoming birth. The emotional state of the mother must remain stable, otherwise it may affect the proper development of the fetus. However, such cases of headache are considered the least dangerous - they are not associated with serious internal disorders and are treated with conservative methods.

Late toxicosis (preeclampsia) is a complication of pregnancy. Nausea, swelling, and headaches in the third trimester cannot be considered normal. In addition, this condition can threaten both the health of the mother and the development of the fetus in the final stages. A diagnosis can be made if three characteristic symptoms are present:

• the appearance of edema;
• hypertension;
• the presence of protein in the urine.

Preeclampsia may be associated with insufficiency of the urinary system and kidney disease. Nephropathy can be diagnosed by a significant increase in blood pressure - this symptom may be absent in hydrops of pregnancy.

One of the most dangerous manifestations of late toxicosis is eclampsia. This is a rare form that is manifested by convulsive muscle contractions and loss of consciousness in response to any irritant. It can be a flash of light or a loud sound. Preeclampsia is a less dangerous condition, but it can also harm the health of mother and baby. It occurs without convulsive syndrome, and its main symptoms are acute headache, dizziness, and a feeling of heaviness in the forehead and occipital region. In addition, during an attack, visual impairment is observed: a veil appears before the eyes, different spots, and in some cases, temporary blindness. Additionally, there are complaints of nausea and vomiting, pain in the right hypochondrium. In such cases, pregnancy should proceed in a hospital setting so that doctors can relieve convulsions and intoxication in a timely manner without harm to the health of the mother and fetus.