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Headaches and Seizures

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Medical Management of the Pregnant Patient

Abstract

Pregnancy and the postpartum state can affect preexisting primary neurological conditions, such as headaches and epilepsy. These disorders and their treatment can also have an effect on maternal and fetal pregnancy outcomes. Both seizures and headaches can occur de novo during pregnancy, and if this is the case, they warrant thorough investigation to exclude secondary causes such as vascular, neoplastic, structural, infectious, or other. Migraine headaches can have hormonal triggers and thus may worsen or improve during pregnancy. Seizures during pregnancy can have adverse effects on the mother or fetus, and the benefit of treatment with antiepileptic drugs (AEDs), while potentially teratogenic, is thought to outweigh the risks of the drugs. Levels of AEDs, at least one per trimester, are useful and can guide therapeutic changes in dosing, given physiologic factors that can precipitate alterations of concentration during pregnancy. Pregnant women, or women contemplating pregnancy, should be counseled about folic acid supplementation and postpartum seizure safety issues.

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Abbreviations

AED:

Antiepileptic drugs

CH:

Cluster headache

CT:

Computerized tomography

EEG:

Electroencephalogram

MRI:

Magnetic resonance imaging

TTH:

Tension-type headache

References

  1. Headache Classification Subcommittee of the International Headache Society (IHS). The International Classification of Headache Disorders. 2nd ed. 1st revision, (ICHD-IIRI), May 2005, http://www.ihs-classification.org.

  2. Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ. 2009;338:b664.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Giraud P, Chauvet S. Cluster headache during pregnancy: case report and literature review. Headache. 2009;49(1):136–9.

    Article  PubMed  Google Scholar 

  4. Pearce CF, Hansen WF. Headache and neurological disease in pregnancy. Clin Obstet Gynecol. 2012;55:810–28.

    Article  PubMed  Google Scholar 

  5. Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. 2008;7:70–83.

    Article  CAS  PubMed  Google Scholar 

  6. MacGregor EA. Headache in pregnancy. Neurol Clin. 2012;30:835–66.

    Article  PubMed  Google Scholar 

  7. Goadsby PJ. Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol. 2002;1:251–7.

    Article  PubMed  Google Scholar 

  8. Cutrer FM. Pathophysiology of migraine. Semin Neurol. 2006;26(2):171.

    Article  PubMed  Google Scholar 

  9. Menon R, Bushnell CD. Headache and pregnancy. The Neurologist. 2008;14:108–19.

    Article  PubMed  Google Scholar 

  10. Harden CL, et al. Practice parameter update: management issues for women with epilepsy. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology. 2009; 73:126–32, 133–41, and 142–9.

    Google Scholar 

  11. Borthen I, Gilhus NE. Pregnancy complications in patients with epilepsy. Curr Opin Obstet Gynecol. 2012;24:78–83.

    Article  PubMed  Google Scholar 

  12. Pennell PB. Antiepileptic Drugs during pregnancy: what is known and which AEDs seem to be safest? Epilepsia. 2008;49 Suppl 9:43–55.

    Article  CAS  PubMed  Google Scholar 

  13. Lindhout D, Omtzigt JG, Cornel MC. Spectrum of neural-tube defects in 34 infants prenatally exposed to antiepileptic drugs. Neurology. 1992;42(4 Suppl 5):111–8.

    CAS  PubMed  Google Scholar 

  14. Chen YH, Chiou HY, Lin HC, Lin HL. Affect of seizures during gestation on pregnancy outcomes in women with epilepsy. Arch Neurol. 2009;66(8):979–84.

    PubMed  Google Scholar 

  15. The North American Antiepileptic Drug Pregnancy Registry. http://www.aedpregnancyregistry.org

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Author information

Authors and Affiliations

  1. Department of Neurology, Comprehensive Epilepsy Program, Rhode Island Hospital, 110 Lockwood Street, Suite 342, Providence, RI, 02903, USA

    Julie L. Roth M.D.

  2. The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Julie L. Roth M.D.

  3. Department of Obstetric Medicine, Women’s Medicine Collaborative, Miriam Hospital, 146 West River Street, Ste 11C, Providence, RI, 02904, USA

    Courtney Bilodeau M.D.

  4. The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Courtney Bilodeau M.D.

Authors
  1. Julie L. Roth M.D.
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  2. Courtney Bilodeau M.D.
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Corresponding author

Correspondence to Julie L. Roth M.D. .

Editor information

Editors and Affiliations

  1. SVP Women’s Services and Clinical Integration, Lifespan Corporation, Professor and Vice Chair of Medicine Director of Obstetric Medicine, Alpert Medical School at Brown University, Providence, Rhode Island, USA

    Karen Rosene-Montella

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Roth, J.L., Bilodeau, C. (2015). Headaches and Seizures. In: Rosene-Montella, K. (eds) Medical Management of the Pregnant Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1244-1_10

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  • DOI: https://doi.org/10.1007/978-1-4614-1244-1_10

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1243-4

  • Online ISBN: 978-1-4614-1244-1

  • eBook Packages: MedicineMedicine (R0)

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