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Migraines increase the chance of problems during pregnancy.

Migraines increase the chance of problems during pregnancy.

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A sizable prospective study was carried out by scientists at Brigham and Women’s Hospital in Boston to learn more about the link between migraines and unfavorable pregnancy outcomes.

According to their findings, women with pre-pregnancy headaches had a 40% increased risk of preeclampsia, a 28% increased risk of gestational hypertension, and a 17% increased risk of premature delivery.

These findings, according to the researchers, point to the potential advantage of greater monitoring for pregnant women who have a history of migraines.

Compared to men, women have a 2 to 3 times higher lifetime risk of developing migraines, which are most prevalent in women between the ages of 18 and 44.

Before a migraine attack, some people see an “aura” that frequently consists of flashing lights in their range of vision.

An aura-specific migraine, in particular, has been linked to a two-fold increased risk of myocardial infarction and stroke, according to a recent meta-analysis.

The molecular factors linked to cardiovascular risks in migraine sufferers may also raise the chance of pregnancy difficulties, according to a research hypothesis.

Meanwhile, little research has examined the connection between migraine and difficulties during pregnancy. Small study populations, a lack of knowledge about potential confounding variables, and the migraine phenotype (with or without aura) are the limitations of these investigations.

To fill in these knowledge gaps, scientists from Brigham and Women’s Hospital in Boston created a significant prospective study to calculate the correlations between pre-pregnancy migraine and the risk of gestational diabetes, gestational hypertension, pre-eclampsia, pre-term delivery, and low birth weight.

The researchers also looked at potential effect modification by aspirin use and examined whether these relationships varied by migraine phenotype in the study, which was published in the journal Neurology.

Study on migraines and pregnancy

Data from the Nurses’ Health Study II (NHSII) were used by Brigham instructors Alexandra Cari Purdue-Smithe, Ph.D., and her team to achieve these goals.

In 1989, 116,430 registered nurses in the United States between the ages of 25 and 42 participated in this study. Questionnaires about participants’ lifestyles and health were given out. Every two years, participants in this study were required to answer questions on their lifestyle and general health.

In 2009, participants submitted information on each pregnancy they had ever had, including any unfavorable results. In 2007, participants in the NHSII were asked if they had ever experienced aura along with their migraine headaches.

Any self-reported medical diagnosis of migraine on the 1989, 1993, and 1995 NHSII questionnaires was considered a migraine for the purposes of this study, according to Purdue-Smithe’s team.

They restricted their studies to 30-555 pregnancies in 19,694 women who had no history of cardiovascular disease, type 2 diabetes, or cancer. These pregnancies had to be at least 20 weeks long.

Using log-binomial and log-Poisson models, the researchers determined the relative risk and 95% confidence interval for each unfavorable pregnancy outcome. These models were adjusted for several confounding variables, including age at conception, age at menstruation’s onset, race and ethnicity, body mass index, chronic hypertension, alcohol use, physical activity, smoking status, analgesic use, oral contraceptive use, infertility diagnosis, and the number of births.

Important results of the migraine study

11% of the 19,694 female participants at baseline had ever been diagnosed with a migraine by a doctor.

According to the statistical studies, migraine was not linked to gestational diabetes or low birth weight, but it was linked to a higher risk of preterm delivery by 17%, gestational hypertension by 28%, and preeclampsia by 40%.

For migraine with and without aura, the risk of preterm birth and the risk of gestational hypertension were comparable. However, compared to women who had migraines without aura, those who had migraines with aura had a slightly increased chance of developing preeclampsia.

The researchers also discovered a 45% decreased risk of preterm birth in migraine-prone women who consistently (more than twice a week) took aspirin before becoming pregnant. Although this particular investigation had limited statistical power, the researchers did find that women who reported regularly taking aspirin before becoming pregnant had a qualitatively decreased risk of preeclampsia.

Understanding pregnancy and migraine

The results are significant, according to Dr. Matthew Robbins, an associate professor of neurology at Weill Cornell Medicine in New York who was not involved in the study.

“We already knew that the relative risk of stroke and overall cardiovascular comorbidity is higher in individuals who have migraine with aura,” he told us. “This is based on large, population-based epidemiological studies.” “Now, we know that this risk may also extend to pregnancy-related complications, such as a higher incidence of pregnancy-specific cardiovascular diseases like gestational hypertension and preeclampsia.”

He continued, “The results of this investigation imply that migraine history and, to a lesser extent, migraine phenotype, are therapeutically helpful predictors of pregnancy risks.

Likewise not taking part in the study was Dr. Sarah E. Vollbracht, an associate professor of neurology at Columbia University in New York.

“Given the high prevalence of migraine in women of childbearing age, these findings suggest that migraine screening should be included in initial obstetrical assessments to determine if a woman is at risk of adverse pregnancy outcomes and women with migraine should be closely followed throughout pregnancy and monitored for the development of hypertensive disorders in pregnancy,” she said in a statement to us.

Aspirin use during pregnancy may reduce the risk of preterm birth and preeclampsia, according to the study’s findings, but Vollbracht cautioned that “this finding should be interpreted cautiously” and that “more data, including placebo-controlled studies, is needed to determine the role of aspirin use in pregnant women with migraine.”

Limitations and upcoming studies

The definition of migraine utilized in this study may have understated the actual prevalence of migraine in the study population and, consequently, the relative risks, according to Purdue-Smithe and her co-authors.

Confounding effects from additional factors, such as heredity and drugs specifically designed to treat migraines, cannot be completely ruled out despite the statistical studies taking numerous potential confounding factors into account.

The Nurses’ Health Study II cohort’s limited generalizability is due to the majority of non-Hispanic white study participants.

Future research should focus on including a patient population that is more diverse in terms of racial, cultural, and socioeconomic origins, according to Vollbracht.

She went on to say that “further prospective studies are needed to determine more clearly the difference in risk based on migraine phenotype as well as understanding the influence of attack frequency on the risk of these adverse pregnancy outcomes.”

Additional study is required to better understand how aspirin alters effects, especially in terms of dosage and initiation time.

Future research may need to evaluate the use of daily aspirin during the second and third trimesters as a preventive intervention against preeclampsia for pregnant women with migraine with aura, according to Robbins.

The researchers concluded by saying that further investigation should aim to shed light on the mechanisms behind the connections found in this study.

REFERENCES:

For Migraine medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=17

Possible link between migraine and carpal tunnel syndrome.

Possible link between migraine and carpal tunnel syndrome.

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Researchers looked into the prevalence of migraine headaches in patients who have nerve decompression surgery.

They discovered that people who have surgery to decompress a nerve at particular points on their bodies may be up to 70% more likely to get migraines than others who have the procedure elsewhere.

To determine whether nerve decompression can treat migraines, more research is required.

There may be pain and a loss of function when the nerves in the hands and arms contract around muscles and soft tissues. Between 5% and roughly 9% of the population are affected by various types of nerve compression in these places.

Surgery is frequently used to treat the illness and might result in full or partial symptom relief.

The muscles, blood arteries, and bone in the vicinity of the head’s surrounding nerves can also compress those nerves. Improvement or alleviation from migraine and headaches may result by decompressing these nerves.

What is Carpal tunnel syndrome?

Carpal tunnel syndrome is caused by compression of the median nerve. On the hand’s palm side, the carpal tunnel is a small opening encircled by bones and ligaments. Numbness, tingling, and weakness in the hand and arm are signs of median nerve compression.

Carpal tunnel syndrome can be caused by repetitive hand motions, health issues, and wrist morphology.

The tingling and numbness are typically reduced with appropriate care, and wrist and hand function is recovered.

Symptoms

The following list of signs and symptoms of carpal tunnel syndrome includes:

Feeling tingly or numb. Numbness and tingling in the fingers or hand may be apparent. Normal afflicted fingers include the thumb, index, middle, and ring fingers, but not the little finger. In certain fingers, you might experience something like to an electric jolt.

The wrist may feel the sensation before it moves up the arm. These symptoms may awaken you from sleep and frequently happen while you are holding the phone, newspaper, or steering wheel.

To try to alleviate their symptoms, many people “shake out” their hands. Over time, the numb sensation could persist continuously.

Weakness. You can feel weak in your hands and drop things. This can be because the thumb’s pinching muscles, which are similarly regulated by the median nerve, are weak or because the hand is numb.

Migraine and carpal tunnel syndrome

When the nerve that travels from the forearm to the palm of the hand is squeezed at the wrist, carpal tunnel syndrome develops.

In comparison to 16% of those without carpal tunnel syndrome, 34% of those with the condition get migraines, according to a cross-sectional study with 25,880 participants. It might be more effective to screen patients for the disorders if it is known whether nerve compression around the head is related to nerve compression in the hands and arms.

Researchers looked at how frequently people who had nerve decompression surgery for the hands and arms were diagnosed with migraines.

According to their findings, people who have particular types of nerve compression are more prone to suffer from migraine headaches. Not a part of the study, Dr. Chantel Strachan is an internist at ColumbiaDoctors and an assistant professor of medicine at Columbia University Irving Medical Centre in New York. She said.

“I wouldn’t jump to advise carpal tunnel release in every migraine patient. The choice to proceed with surgical treatment for nerve compression is specific to the patient and should be carefully considered with the patient’s medical care team.

Journal of Plastic and Reconstructive Surgery published the findings.

Most likely to experience migraine

Data from 9,558 patients who underwent nerve decompression surgery of the hands and arms between 2009 and 2019 were analysed for the study.

Participants were also evaluated by the researchers for the presence of migraine.

Of the subjects, the median nerve was decompressed in about 71% of cases. Surgery is done on the wrist to release pressure on the nerve, which lessens carpal tunnel syndrome symptoms.

A decompression of the ulnar nerve was done on about 14% of subjects. That is an elbow nerve decompression. 6.5% of patients underwent decompression procedures at various body locations.

In the end, the researchers discovered that people with multiple nerve decompression and median nerve decompression were respectively 30% and 70% more likely to experience migraines than people with ulnar nerve decompression.

Nerve compression and migraine

Dr. Sean Ormond, a specialist in anesthesiology and interventional pain management, did a study to learn more about the potential connection between nerve decompression and migraine.

He mentioned that there are a number of possibilities, but that the causes of nerve compression in the arms and hands and migraine are not entirely known.

“Both upper extremity nerve compression syndromes and migraine may share common risk factors, such as obesity, sedentary lifestyle, poor posture, or repetitive stress injuries,” stated Dr. Ormond.

The affected area may experience inflammation as a result of nerve compression. It is also recognised that inflammation contributes to the pathophysiology of migraines. The presence of inflammation in one place of the body may cause inflammation to spread throughout the body, potentially aggravating migraines, the doctor added.

Ormond observed that although further research is need to establish this, some people may be more prone to higher nerve compression and migraine due to a hereditary tendency.

According to Dr. Strachan, migraine sufferers may become more sensitive to pain due to nerve damage.

Limitations of the migraine study

Dr. Strachan pointed out that because the study was retrospective in nature, the results suggest association rather than causality.

She stated that different providers and their subspecialties, such as primary care, neurology, and pain, may have utilised different criteria to diagnose migraine.

The association between migraine and pain from nerve compression may be the consequence of other variables, as the researchers stated in their report that there is a general overlap across chronic pain disorders.

REFERENCES:

For Migraine disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=17