China
Africa
Explore chapters and articles related to this topic
Disorders of the nervous system
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
A particularly debilitating migraine known as hemiplegic migraine can cause temporary muscle weakness on one side of the body, and partial or complete loss of vision. This loss of function can last several hours, and differentiating this from features of a stroke is challenging. Very rarely hemiplegic migraine does lead to stroke in pregnancy9. See Box 8.18 for the management of migraines in pregnancy.
Neurological problems
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Sumatriptan (Imigran®), and other 5-HT1 agonists are commonly used in nonpregnant women for control of acute attacks. The limited data of their use in pregnancy are reassuring with no documented increase in malformations. If these are the only agents that successfully treat an acute attack, then it is reasonable to use them sporadically in pregnancy. They should not be used in hemiplegic migraine.
Neurology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Fenella Kirkham, Adnan Manzur, Stephanie Robb
Full neurological and general examination should be performed on two occasions. A simple analgesic can be prescribed as soon as the child knows the migraine is starting. Reassurance and removal of triggers (e.g. lack of regular food or sleep) with relaxation techniques to combat stress and psychological support and a 3-month trial of a diet free of chocolate, cheese (including pizza) and oranges (including juice) works for the majority of children. Prophylactic medications include pizotifen (but this may cause weight gain), propranolol (contraindicated in asthma), sodium valproate and topiramate. Verapamil may help those with hemiplegic migraine. Rapidly absorbed triptans as nasal spray or buccal wafers may occasionally be taken at the onset of symptoms in children with very severe migraines. Oxygen may be used for cluster headache and indomethacin for hemicrania continua.
An update on EEG in migraine
Published in Expert Review of Neurotherapeutics, 2019
In familial hemiplegic migraine, coexistence of epilepsy is possible, although EEG may be free of epileptic abnormalities. In this rare disease, unspecific EEG abnormalities, such as diffuse or lateralized abnormal slow activity, persist in the follow-up recordings. However, they remain stable over time and do not have a prognostic valence for clinical outcome(s) [15,16] (Table 1). Considering the lack of randomized controlled studies investigating the clinical valence of spontaneous EEG in the differential diagnosis between epileptic seizures or transient neurological deficit and migraine with aura subtypes, we can conclude that there is insufficient evidence supporting the utility of EEG, even in patients with basilar and hemiplegic migraine.
A rational approach to migraine diagnosis and management in primary care
Published in Annals of Medicine, 2021
Vincent T. Martin, Alexander Feoktistov, Glen D. Solomon
The clinical scenarios, advanced neuroimaging data, and experimental neurophysiological findings show that imbalance in inhibitory/excitatory cortical circuits allowing demodulation of subcortical areas is responsible for activation of trigeminovascular system. Hence, demonstrating that activation of trigeminovascular system is not exclusive cause but among main causes of migraine attack [38]. Hemiplegic migraine is a rare subtype of migraine with aura and genetically heterogenous condition. Mutations in the CACNA1A, ATP1A2, and SCN1A genes have been reported to cause these disorders [39]. Many researchers have also indicated the possibility of involvement of PRRT2 gene in migraine pathophysiology. However, further evidence and genetic analyses are required [39–41].
Emerging drugs for the preventive treatment of migraine: a review of CGRP monoclonal antibodies and gepants trials
Published in Expert Opinion on Emerging Drugs, 2023
Marcello Silvestro, Ilaria Orologio, Mattia Siciliano, Francesca Trojsi, Alessandro Tessitore, Gioacchino Tedeschi, Antonio Russo
According with the commonly used criteria, derived from expert opinion, a preventive treatment should be considered in patients with at least four means monthly migraine days (MMD) or even less than 4 days if really disabling due to ineffective (or contraindicated) abortive medications or particular migraine phenotypes (e.g. hemiplegic migraine or migraine with brainstem aura) [11]. In this population, preventive migraine treatment should be considered to reduce migraine-related disability and improve quality of life (QoL) over and above the mere improvement of attack frequency, duration and severity [12]. Reduction≥50% of MMD represent the threshold to consider a preventive migraine treatment as effective [13].