Title: Neurological Conditions Affected by Pregnancy<br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The hormonal changes and hypercoagulable state associated with pregnancy can contribute to neurological conditions.</span></span></li>
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                <em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Migraine</span></span></em>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Migraines decrease in frequency through second trimester with increased estrogen, while increase in frequency postpartum with drop in estrogen, stress, and sleep deprivation.</span></span></li>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Women with history of migraine have higher risk of preeclampsia (odds ratio 2.87).</span></span></span></span></li>
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                <em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Reversible Cerebral Vasoconstriction Syndrome (RCVS)</span></span></em>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Pregnancy is a risk factor for RCVS with 2/3 of cases of pregnancy-related RCVS occurring in the postpartum period.</span></span></span></span></li>
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                <em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Cerebral Venous Thrombosis (CVT)</span></span></em>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">CVT is associated with the hypercoagulable state in late pregnancy and postpartum period, though often associated with additional source of hypercoagulability.</span></span></span></span></li>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Other risk factors include older maternal age, cesarean delivery, smoking, and dehydration.</span></span></span></span></span></span></li>
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                <em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Bell’s Palsy</span></span></em>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Bell’s Palsy is more prevalent in pregnancy, occurring in the third trimester and the first week postpartum.</span></span></span></span></li>
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        <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><u><strong>Bottom Line</strong></u><strong>:</strong> Pregnancy is associated with an increased risk for RCVS, CVT, and Bell’s Palsy. Pregnancy also affects the frequency of migraines due to hormonal fluctuations.</span></span></p>
<fieldset><legend>References</legend>

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                <span style="font-family: arial, helvetica, sans-serif; font-size: 14px;">O’Neal MA. Obstetric and gynecologic disorders and the nervous system. <em>Continuum (Minneap Minn)</em>. 2020;26(3 Neurology of Systemic Disease):611-631.</span></li>
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