Acute Migraine Therapy During Pregnancy: A Primer

Anna Pace, MD


February 15, 2019

Editorial Collaboration

Medscape &

The patient meets the International Classification for Headache Disorders (ICHD-3) diagnostic criteria for migraine without aura. Her headaches include three of the four phenotype characteristics (severe, throbbing, unilateral, worsened with routine physical activity) and one of the two associated symptom requirements (nausea and/or vomiting, photophobia, and phonophobia). Her migraines are episodic, as they occur fewer than 15 days monthly. Patients meeting all of the criteria except for one are diagnosed with probable migraine if a secondary diagnosis has been excluded.

Physical Examination

The patient appears well. Her blood pressure is 122/84. Her heart rate is 70. She is afebrile. Funduscopic exam reveals sharp discs bilaterally. Her neurologic examination is normal. She has some tenderness to palpation over the right temple and bilateral greater occipital ridges.


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