Table 4 Patients treating during pregnancy
Patient 1 | Patient 2 | Patient 3 |
|---|---|---|
Age: 29. Episodic Migraine with Aura. | Age: 30. Chronic Migraine without aura. | Age: 32. Chronic Migraine without aura. |
Pre-pregnancy migraine pattern: | Pre-pregnancy migraine pattern: | Pre-pregnancy migraine pattern: |
Frequency: 12 days/month. Duration: 0.5–1 day. | Frequency: 10 days/month plus daily background pain. | Frequency: 15 days/month. Duration: 1–2 days. |
Treatment: Triptan and sleep. | No effective treatment. | Treatment: frovatriptan, Syndol (paracetamol [acetaminopheno] + codeine + doxylamine + caffeine) and Naproxen, goes to bed. |
During pregnancy: | During pregnancy: | During pregnancy: |
Frequency: 2–4 days per week, Duration of 2–3 days, severe and in bed. Estimated 90 % reduced ability to function. | 16 days: acute attacks plus daily background pain. Duration: 1 day. Estimated 50 % reduced ability to function. | Treatment: Dihydocodeine during the early pregnancy with partial benefit. Estimated 60 % reduced ability to function. |
TMS response: 2 consecutive pulses repeated after 15 min. Consistent reduced pain severity and duration. Could return to function and did not need to go to bed. | TMS response: 4 pulses per day (2 consecutive pulses repeated after 15 min). Stopped attack escalation and reduced the severity back down to a mild tolerable level within 1–2 h. Associated symptoms resolved or did not develop. | TMS response: a single pulse repeated after 15–30 min; up to 4 pulses per attack. Initially combined with dihydrocodeine. Subsequently used sTMS only and could abort the attack within an hour. Associated symptoms rarely developed. |