Bob Johnson
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"Only the educated are free." -Epictetus
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Headache. 2009 Jan;49(1):136-9. Cluster headache during pregnancy: case report and literature review.
Giraud P, Chauvet S.
Centre hospitalier d'Annecy, Service de Neurologie, Metz-Tessy, France.
A 32-year-old pregnant woman presented with cluster headache (CH) during the third trimester of a normal pregnancy. Pure oxygen mask inhalation was ineffective, and intranasal lidocaine applications were realized associated with oral methylprednisolone, given at 1 mg per kg once daily. These treatments rendered the pain tolerable and the pregnancy went to its term with no consequence on the baby. This case of CH attack during pregnancy raises the issues of the influence of sexual hormonal changes in women with CH and the way to treat this disease in such circumstance. To date, there are no therapeutic guidelines available; this case suggests some possibilities.
PMID: 19125883 [PubMed =================
I have two longer articles which I can send via e-mail. They are PDF files, so you need a reader. If you want them send me your e-mail address via PM. ====== ====== After posting this stuff, did some more digging and found:
Cephalalgia. 2009 Jan 19. [Epub ahead of print] Treatment of cluster headache in pregnancy and lactation.
Jüergens TP, Schaefer C, May A.
Department of Neurology, University of Regensburg, Regensburg, Germany.
Jüergens TP, Schaefer C & May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia 2009. London. ISSN 0333-1024Cluster headache is a rare disorder in women, but has a serious impact on the affected woman's life, especially on family planning. Women with cluster headache who are pregnant need special support, including the expertise of an experienced headache centre, an experienced gynaecologist and possibly a teratology information centre. The patient should be seen through all stages of the pregnancy. A detailed briefing about the risks and safety of various treatment options is mandatory. In general, both the number of medications and the dosage should be kept as low as possible. Preferred treatments include oxygen, subcutaneous or intranasal sumatriptan for acute pain and verapamil and prednisone/prednisolone as preventatives. If there is a compelling reason to treat the patient with another preventative, gabapentin is the drug of choice. While breastfeeding, oxygen, sumatriptan and lidocaine for acute pain and prednisone/prednisolone, verapamil, and lithium as preventatives are the drugs of choice. As the individual pharmacokinetics differ substantially, adverse drug effects should be considered if unexplained symptoms occur in the newborn.
PMID: 19170693
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