Pregnancy migraine

For migraine headache during pregnancy, rest, reassurance, and ice packs should be used initially. If drug therapy is needed, acetaminophen is first-line therapy. 

NSAIDs are contraindicated after 37 weeks gestation. For refractory migraines, narcotics may be used. Salicylates and indomethacin should be avoided throughout pregnancy if possible. The use of sumatriptan is controversial. Nausea of migraines may be treated with metoclopramide. 

Phenobarbitone is used to treat epilepsy, migraine headache, dental infections, pregnancy vomiting, tetanus, enuresis, chorea, pre and post operative sedation, hypertension, anxiety states, neurosis, and in the treatment of drug and alcohol addiction. This drug is also called phenobarbital. 

There is no evidence that ordinary use of ergotamine for migraine is hazardous in pregnancy. However, most clinicians counsel restraint in the use of the ergot derivatives by pregnant patients. 

Dong quai has been used in the treatment of dysmenorrhea, amenorrhea, metorrhagia, menopausal syndromes, anemia, abdominal pain, injuries, migraine headaches, and arthritis. It is believed to ensure healthy pregnancies and easy deliveries. In the U.S., dong quai is recommended primarily to alleviate problems associated with menstruation and menopause. 

Tegeler GH, Shi F, Morgan T (1991). Carotid stenosis in lacunar stroke. Stroke 22 1124-1128 Tietjen GE (2005). The risk of stroke in patients with migraine and implications for migraine management. CNS Drugs 19 683-692 Turan TN, Stern BJ (2004). Stroke in pregnancy. 

---