Neuro symptoms in pregnancy rarely stroke-related
Neurological symptoms that occur during pregnancy are rarely caused by a mini-stroke, or “transient ischemic attack” (TIA), but instead are usually associated with migraine with “aura,” according to a report in BMC Medicine.
Aura refers to symptoms that may precede the onset of a migraine (and also seizures), such as seeing flashing lights or temporary vision loss.
“The positive message is that women with migraine aura in pregnancy do not seem to be at any great risk for developing TIAs or (related) disorders,” Dr. Lars Jacob Stovner from the Norwegian University of Science and Technology, Trondheim, told Reuters Health.
Stovner and associates note that it may be difficult to differentiate auras associated with migraine from TIAs and other disorders in pregnant women. To further investigate, the researchers evaluated 41 women who experienced transient neurological symptoms during pregnancy, comparing them with healthy women.
Migraine aura proved to be the main diagnosis in 34 of the patients, the team reports. Among the others, 2 patients had carpal tunnel syndrome, 2 had a stroke, 1 had partial epilepsy, 1 had multiple sclerosis, and 1 had fainting spells.
In nearly all the women, no abnormalities were noted on physical examination.
Neurological symptoms were most common in the third trimester of pregnancy and least common during the first trimester, the report indicates.
Patients and healthy subjects reported no differences in headaches before pregnancy, the investigators say, though 18 of the women with neurological symptoms experienced migraine attacks prior to pregnancy.
Extensive investigation among women with migraine aura failed to detect evidence of stroke-related disease, and none of the women went on to develop a stroke or TIA during 5 years of follow-up.
Stovner urges doctors to learn the symptoms that distinguish mini-strokes from migraine with aura.
SOURCE: BMC Medicine, July 17, 2007.
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