Treatment of Migraine with Brainstem Aura in Pregnancy

Managing migraine with brainstem aura during pregnancy requires careful consideration of gestational timing, as the range of safe analgesic options changes across trimesters.

Clinical scenario

This protocol addresses migraine with brainstem aura occurring in pregnant patients. Pregnancy is the defining condition shaping treatment selection, with gestational stage determining which analgesic agents are appropriate and which must be avoided.

Treatment approach

Analgesic treatment follows a trimester-sensitive strategy — certain agents are appropriate during the first and second trimester, while significant restrictions apply in the third, and alternative options exist only when primary agents are contraindicated.

Full drug selection, sequencing, and contraindication guidance available in the complete protocol →

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References

DOI: 10.1177/2514183X1882337

Migraine attacks can be treated between the first and second trimenon of pregnancy with ASA or ibuprofen.
These substances should be avoided in the third trimenon.
Paracetamol should only be given if there are contraindications for ASA.

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