Full Question:

What My daughter is 30 and has suffered with migraines for about 2 years now and sometimes they come and last for days. She has had an MRI and all kinds of test down but they cannot find out why she gets them and nothing relieves them when they come. Well she is now 7 weeks pregnant and has been hospitalized 3 times for these headaches. She is now in the hospital again and has low potassium a 3.0 and low magnesium and has had a migraine for 3 weeks now that is sometimes unbearable. A neurolgist and her OB/GYN are working together but nothing seems to work. They have given her morphine, Topomax some other stuff and now she is on Midrin can any of these medications harm the baby in any way? She was seeing a chiropractor for a while for her TMJ and his treatments seemed to help with her headaches a little, Can TMJ and migraines be linked and do you think acupuncture could help her. Thank You, Pat.
 

Answer:

Dear Pat;

Especially with low magnesium, one thing for her to discuss with her doctor is an IV infusion of magnesium sulfate. A magnesium sulfate IV infusion will often stop even Migraines that are resistant to medications. See IV Treatment of Refractory Migraines for more information on this.

There's a new study about Topamax that she and her doctors should know about. It indicates that Topamax taken during pregnancy can increase the possibility of some birth defects. See Migraine Preventive Topamax May Cause Birth Defects for more details.

Midrin is pregnancy category C, which means that animal studies have shown fetal problems, but that human studies have been inconclusive or haven't been done. With category C drugs, risks and benefits need to be weighed to make a decision about using them. Morphine is also category C, but there are specific warnings about some trimesters of pregnancy. Her doctor would have that information.

TMJ can trigger Migraines, but a chiropractor is generally not the best for treating it. A dentist with experience treating TMJ is often better for this. There is, in fact, a dental appliance designed specifically to treat Migraineurs with dental issues that trigger Migraines. It's called an NTI-TSS appliance. A consultation with a dentist who works this this appliance could also be helpful.

Neurologists aren't necessarily Migraine specialists, so a consultation with a Migraine specialist could be very helpful. There's a link below to our directory of patient recommended specialists.

We hope this helps and that your daughter's pregnancy gets easier.

Good luck,
John Claude Krusz and Teri Robert

About Ask the Clinician:

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.