The hormonal changes and hypercoagulable state associated with pregnancy can contribute to neurological conditions.
Migraine
Migraines decrease in frequency through second trimester with increased estrogen, while increase in frequency postpartum with drop in estrogen, stress, and sleep deprivation.
Women with history of migraine have higher risk of preeclampsia (odds ratio 2.87).
Pregnancy is a risk factor for RCVS with 2/3 of cases of pregnancy-related RCVS occurring in the postpartum period.
Cerebral Venous Thrombosis (CVT)
CVT is associated with the hypercoagulable state in late pregnancy and postpartum period, though often associated with additional source of hypercoagulability.
Other risk factors include older maternal age, cesarean delivery, smoking, and dehydration.
Bell’s Palsy
Bell’s Palsy is more prevalent in pregnancy, occurring in the third trimester and the first week postpartum.
Bottom Line: 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.
References
O’Neal MA. Obstetric and gynecologic disorders and the nervous system. Continuum (Minneap Minn). 2020;26(3 Neurology of Systemic Disease):611-631.
