medigraphic.com

2019, Number 6

<< Back Next >>

Rev Clin Esc Med 2019; 9 (6)

Abordaje terapéutico de la migraña en la mujer embarazada y en lactancia

Sequeira QCM

Language: Spanish
References: 27
Page: 21-30
PDF size: 398.01 Kb.


ABSTRACT

Migraine is the most common primary headache seen in the first level of attention causing disability. It is more common in women and especially during reproductive ages, showing a relationship with levels of estrogen and progesterone, as well as with the fluctuations in both. During pregnancy, migraine in women can appear for the first time, get worse or more frequently improve. Its diagnosis is centered in the detection of red flags that might suggest a secondary headache. The therapeutic approach can be divided in pharmacologic and nonpharmacologic options, the first one subsequently subcategorized in drugs for prophylaxis and acute treatment. Among the medications available are beta blockers and amitriptyline for prevention, while acetaminophen is used for the acute pain attacks. The prescription of triptans, especially sumatriptan, appears to the safe, nonetheless it is preserved as a third line treatment. Opioids despite its effectiveness are not recommended. Recommendations during breast-feeding follow a similar line.


REFERENCES

  1. Daroff R Jankovic J Mazziotta J. Bradley’s Neurology in Clinical Practice. Seventh Edition. Chapter 103: Headache and other Craniofacial Pain. Elsevier. 2016; 1686-1759.

  2. Hauser L Stephenson A. Harrison’s Neurology in Clinical Medicine. 4th Edition. Chapter 9: Headache. Mc- GrawHill Education. 2017;100-106.

  3. Rooper A Samuels M Klein J. Adams and Victor’s Principles of Neurology. Chapter 10: Headache and other craniofacial pains. McGraw-Hill education. 2014;

  4. Samuels M Rooper A. Samuels’s Manual of Neurologic Therapeutics. Ninth Edition. Chapter 12: Headache and Facial Pain. Wolters Kluwer. 2017; 407-416.

  5. Olesen J Bendtsen L Dodick D. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33(9): 629–808.

  6. Pavlovic J Akcali D Bolay H. Sex related Influences in Migraine. Journal of Neuroscience Research. 2017; 95: 587–593.

  7. MacGregor A. Migrain Management During Menstruation and Menopause. Continuum (Minneap Minn). 2015;21(4):990–1003.

  8. Grotta K MacGregor E. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017; 16: 76–87.

  9. Pakalnis A. Migraine and Hormones. Semin Pediatr Neurol. 2016; 23: 92-94.

  10. Pavlovic J Allshouse A Santoro N. Sex hormones in women with and without migraine: evidence of migraine- specific hormone profiles. Neurology. 2016; 87:49– 56.

  11. MacGregor E. Headache in Pregnancy. Neurol Clin 30. 2012; 835–866.

  12. Sacco S Ripa P. Migraine in Pregnancy. The Journal of Headache and Pain. 2015 16(1):1.

  13. Tepper D. Pregnancy and Lactation – Migraine Treatment. Headache: The Journal of Head and Face Pain. 2015: 1-2.

  14. Macgregor E. Headache in Pregnancy. Continuum (Minneap Minn) 2014;20(1):128–147.

  15. Robbins M. Headache in Pregnancy. CONTINUUM (MINNEAP MINN) 2018;24(4, HEADACHE): 1092– 1107.

  16. Bove E Klein J. Neuroradiology in Women of Childbearing Age. Continuum (Minneap Minn). 2014;20(1):23–41.

  17. Drugs. FDA Pregnancy Categories. Obtenido de: https://www.drugs.com/pregnancy-categories.html

  18. Federal Register. Content and Format of Labeling for Human Prescription Drug and Biological Products; Requirements for Pregnancy and Lactation Labeling. Obtenido de: https://www.federalregister. gov/documents/2014/12/04/2014-28241/ content-and-format-of-labeling-for-human-prescription- drug-and-biological-products-requirements-for

  19. FDA. Drugs in Pregnancy and Lactation: Improved Benefit-Risk Information. Obtenido de: https://www. fda.gov/downloads/Drugs/DevelopmentApprovalProcess/ SmallBusinessAssistance/UCM431132.pdf

  20. Wald T Walling A. Headache during pregnancy. Obstetrical and Gynecological Survey. 2002. 57 (3): 1-7.

  21. The Medical Letter. Drugs for Migraine. The Medical Letter. 2017 Feb; 59: 1-9.

  22. Eskerud G Wood M Eberhard M. Patterns and predictors of analgesic use in pregnancy: a longitudinal drug utilization study with special focus on women with migraine. BMC Pregnancy and Childbirth. 2017; 17: 1-11.

  23. Amundsen S Nordeng H Nezvalova K. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat. Reviews. Neurol. 2015; Marzo: 1-12.

  24. Hutchinson S Marmura M Calhoun A. Use of common migraine treatments in Breast-Feeding Women: a summary of recommendations. Headache. 2013 Abril; 53 (4): 614-627.

  25. Pringsheim T Davenport W Mackie G. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012 Mar; 39(2): 1-24.

  26. 26.Chou T Hsien T. Medical Treatment Guidelines for Preventive Treatment of Migraine. Acta Neurologica Taiwanica. 2017; 26 (1): 1-21.

  27. Govindappagari S Grossman T Dayal A. Peripheral Nerve Blocks in the Treatment of Migraine in Pregnancy. Obstet Gynecol. 2014; 124:1169–74.




2020     |     www.medigraphic.com