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What is AHA Life´s Essential 8 factors\u27 role in preventing migraine chronification? Insights from a 4-year follow-up with 4,193 participants in the ELSA-Brasil study
Full text linkBackground: Migraine chronification is believed to depend on lifestyle and other health factors. However, there is a scarcity of studies evaluating whether well-established lifestyle and health factors can reduce the risk of migraine chronification. Objective: We aimed to evaluate the risk of migraine chronification considering the recommended adherence to Life´s Essential 8 (LE8) behavior (diet, physical activity, sleep, and nicotine exposure) and health (body mass index, blood lipids, blood glucose, and blood pressure) factors scores proposed by the American Heart Association (AHA) in a middle-aged population. Methods: This is a prospective analysis based on the exposure to LE8 factors at the baseline (2008-2010) and migraine chronification at the inter-wave (2012-2014) among participants with migraine diagnosis at baseline from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The LE8 factors scores were computed following the AHA´s scoring system. Migraine chronification was defined as the change in migraine attack frequency from < 15 days/month to ≥15 days/month from baseline to follow-up period. Modified Poisson regression models estimated the risk ratio (RR) with a 95% confidence interval for migraine chronification, according to the adherence levels to the LE8 factors categorized as low (reference), moderate, and high (recommended). Results: Participants with migraine attack frequency ≥ 15 days/month at baseline were excluded (n = 100). Among 4,193 participants included (mean age: 51.3, ±8.9 years, 54.1% female), 241 (5.7%) presented with migraine chronification at follow-up. The mean (SD) follow-up period was 4.0 (0.38) years. Prevalence of recommended adherence to LE8 factors was 12.6% and 6.2% among controls and migraine chronification groups, respectively. In the model adjusted for sex, age, race, household income, education, marital status, and migraine preventive medication, achieving the recommended adherence to LE8 global factors was associated with lower migraine chronification risk (RR: 0.376 [0.203, 0.69], p=0.002). Achieving the recommended adherence to LE8 behavior domain (RR: 0.47 [0.272, 0.82], p=0.008) was associated with lower migraine chronification risk but not LE8 health domain (RR: 0.84 [0.51, 1.39], p=0.518). Conclusion: In the ELSA-Brasil study, the high adherence to AHA LE8 factors, mostly behavior factors, was associated with a lower risk of migraine chronification
Fibromigrânea: um estudo de coorte retrospectivo
No full textObjectivesTo diagnose fibromyalgia in patients with migraine and assess the quality of life of these patients. Patients and MethodsA prospective, cross-sectional study was carried out, comparing groups, in a non-randomized sample, consisting of patients diagnosed with migraine. The sample was evaluated using the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS) questionnaires to diagnose fibromyalgia. Quality of life and level of depression were assessed, respectively, using the Headache Impact Test-6 (HIT-6) and Patient Health Questionnaire-9 (PHQ-9). ResultsWe interviewed 100 patients (5 men and 95 women) diagnosed with migraine, with a mean age of 37.1±11.0 years, ranging from 19 to 64 years. Thirty-four patients (34%) had migraine and fibromyalgia concomitantly. Migraine predominated in females, both in the presence and absence of fibromyalgia. In both groups, there was no difference in headache characteristics. In the group with fibromyalgia, there was a predominance of allodynia and a higher PHQ-9 score (p<0.001). ConclusionsPatients with migraine are more predisposed to depression when there is an association with fibromyalgia.ObjetivosDiagnosticar fibromialgia em pacientes com migrânea e avaliar qualidade de vida desses pacientes.Pacientes e MétodoFoi realizado estudo prospectivo, transversal, com comparação de grupos, em amostra não randomizada, constituída de pacientes diagnosticados com migrânea. A amostra foi avaliada através dos questionários Widespread Pain Index (WPI) e Symptom Severity Scale (SSS) para diagnosticar fibromialgia. A qualidade de vida e o nível de depressão foram avaliados, respectivamente, pelo Headache Impact Test-6 (HIT-6) e Patient Health Questionnaire-9 (PHQ-9). ResultadosForam entrevistados 100 pacientes (5 homens e 95 mulheres) diagnosticados com migrânea, com uma média de idade igual 37,1±11,0 anos, variando de 19 a 64 anos. Trinta e quatro pacientes (34%) tinham migrânea e fibromialgia, concomitantemente. A migrânea predominou no sexo feminino, tanto na presença quanto na ausência de fibromialgia. Nos dois grupos, não houve diferença nas características da cefaleia. No grupo com fibromialgia, houve predominância de alodínia e um maior escore em PHQ-9 (p<0,001). ConclusõesPacientes com migrânea estão mais predispostos a apresentar depressãoquando há associação de fibromialgia
Hipertensão e enxaqueca: uma análise bibliométrica
No full textIntroduction
Hypertension, or high blood pressure, is a common and serious health issue. It has no specific symptoms, and for that, it is called the silent killer. Migraine attacks may be alarming for those with hypertension.
Objective
This review aims to analyze the trending publications concerning hypertension and migraine.
Methods
This bibliometric analysis analyzed the trending publications about hypertension and migraine. The Scopus database was used, and the bibliometric analysis was applied to show the most productive authors, the journals that most contributed in this field, countries, institutions, and keywords used. Hypertension and migraine showed elevated growth in the published articles throughout the years.
Results
For the last ten years, from 2013 to 2022, there has been a dramatic increase, especially in the last few years in publications related to hypertension and migraine. The highest number of publications were in the United States, the most productive authors being Dodick, D.W. and Pezzini, A., Harvard Medical School had the most published articles; and Headache journal was on the top 10 journals that had publications on this subject.
Conclusion
Migraine is recently considered a sign of hypertension, and this bibliometric analysis focused on the remarkable interest that has appeared in the research community.Introdução
A hipertensão, ou pressão alta, é um problema de saúde comum e sério. Não apresenta sintomas específicos e por isso é chamado de assassino silencioso. Os ataques de enxaqueca podem ser alarmantes para quem tem hipertensão.
Objetivo
Esta revisão tem como objetivo analisar as tendências de publicações sobre hipertensão e enxaqueca.
Métodos
Esta análise bibliométrica analisou as tendências de publicações sobre hipertensão e enxaqueca. Foi utilizada a base de dados Scopus e aplicada a análise bibliométrica para mostrar os autores mais produtivos, os periódicos que mais contribuíram nesta área, países, instituições e palavras-chave utilizadas. Hipertensão e enxaqueca apresentaram crescimento elevado nos artigos publicados ao longo dos anos.
Resultados
Nos últimos dez anos, de 2013 a 2022, houve um aumento dramático, especialmente nos últimos anos, nas publicações relacionadas com hipertensão e enxaqueca. O maior número de publicações ocorreu nos Estados Unidos, sendo os autores mais produtivos Dodick, D.W. e Pezzini, A., Harvard Medical School tiveram o maior número de artigos publicados; e a revista Headache ficou entre as 10 principais revistas que tiveram publicações sobre o assunto.
Conclusão
A enxaqueca é recentemente considerada um sinal de hipertensão, e esta análise bibliométrica centrou-se no notável interesse que tem surgido na comunidade científica
MANIFESTAÇÕES OFTALMOLÓGICAS, NEUROLÓGICAS E AUDITIVAS DA SÍNDROME DE SUSAC- RELATO DE CASO
No full textIntroductionThe first case reports of Susac Syndrome emerged in 1979 due to two young female patients presenting with the clinical triad of multifocal encephalopathy, occlusion of the central retinal artery branch, and sensorineural hearing loss, as well as histopathological findings of microinfarctions in the gray and white matter of the brain. The clinical features of the syndrome have been documented in approximately 500 cases published worldwide, making it extremely rare. Headache is a prominent complaint by patients with Susac syndrome. Its pathophysiology remains unknown, with immune and genetic factors being most related to the retino-cochleo-cerebral clinical manifestations. Since its first description, the scientific community has been paying greater attention to the syndrome, especially with advances in medical technology and the availability of complementary exams.Case reportIn this study, We present a case report of a woman experiencing progressive pulsatile temporal headaches for two years, associated with decreased visual acuity for three months and simultaneous hypoacusis on the left, who was incorrectly diagnosed and treated for multiple sclerosis.CommentThe literature review discusses Susac Syndrome and its microvascular complications, highlighting the multidisciplinary approach necessary for accurate diagnosis and comprehensive long-term management.Os primeiros relatos de caso da Síndrome de Susac (SS) surgiram em 1979 devido a duas pacientes do sexo feminino jovens com a tríade clínica - de encefalopatia multifocal, oclusão de ramo da artéria central da retina e perda auditiva neurossensorial- além de achados histopatológicos cerebrais de microinfartos na substância branca e cinzenta do cérebro. As características clínicas da síndrome foram documentadas em aproximadamente 500 casos publicados no mundo, tornando-a extremamente rara. Sua fisiopatologia permanece desconhecida, sendo fatores imunes e genéticos os mais relacionados com as manifestações clínicas retino-cócleo-cerebrais. Desde sua primeira descrição, a comunidade científica vem dando maior atenção à síndrome, principalmente com os avanços médicos e a disponibilidade dos exames complementares. Neste trabalho abordamos um relato de caso e uma revisão de literatura sobre a Síndrome de Susac e seus acometimentos microvasculares, além do trabalho multidisciplinar para realização do seu diagnóstico e acompanhamento a longo prazo
Assessment of Blood Pressure in patients with headache – preliminary data from a Brazilian cohort
Full text linkIntroduction: There is controversy in the literature regarding the relationship between headaches and blood pressure (BP) levels. Studies indicate that patients with headaches have higher, lower or similar BP than those without headaches. Furthermore, headache is widely considered a symptom of elevated BP among patients and physicians. Objective: To evaluate the blood pressure parameters of patients with headaches in a Brazilian cohort. The secondary objectives are to verify whether there is a correlation between headache intensity and mean BP and whether there are differences in these measurements between those with episodic and chronic headaches. Methods: This is an analytical and descriptive study from a cohort of live births from June 1, 1978, to May 31, 1979 (n=6748) in Ribeirão Preto/SP. This collection was carried out between 2016 and 2017 using a semi-structured questionnaire. The averages of 3 measurements taken according to the Brazilian Arterial Hypertension Guidelines were considered for the BP variables. Results: 1775 individuals attended the fourth interview, with an average age of 38.13±0.579, of which 929 (52.3%) were female and an average BMI of 28.75±5.72. Sixty-three percent (n=1113) reported having had a headache in the last three months, with 16.3% (n=181) reporting having chronic headaches (15 or more days of pain per month). Regarding mean systolic blood pressure (SBP), there were no differences between those with headache (122.19±15.24) and those without headache (124.23±14.18), p=0.15. Regarding mean diastolic blood pressure (DBP), no differences were observed between the groups (with headache 78.09±11.43, without headache 78.39±10.22, p=0.59). A negative but negligible correlation existed between mean SBP (r=-0.093, p=0.002) and pain intensity. There was no correlation between mean DBP (-.036, p=0.229) and pain intensity. we compared those with chronic headache (n=181) with those with episodic headache (n=927), there were no differences in mean SBP (121.62±15.72 versus 122.23±15.04, p=0.61) and DBP (78.98±12.37 versus 77.87±11.19, p=0.293). Conclusion: There were no differences in the mean BP of patients with headaches compared to those without. There were no differences in mean SBP and DBP between individuals with episodic and chronic headaches. Moreover, there was no correlation between SBP or DBP averages and pain intensity
Síndrome da Boca Ardente: Uso Concomitante de Rizotomia do Trigêmeo e Esfenopalatino
No full textIntroduction: Burning Mouth Syndrome (BMS) is neuropathic pain resulting from injury or pathology affecting the peripheral or central somatosensory system. Its symptoms include intraoral burning, and it is important to rule out other conditions with similar manifestations. This pain may be localized to the tongue or its tip and may be related to dysesthesia, taste dysfunction, and the sensation of dry mouth. It can be episodic or continuous with variable duration, typically resembling an electric shock in the former case and a burning sensation in the latter. It predominantly affects postmenopausal women, and studies suggest that sensory neuropathy of the small fibers of the trigeminal nerve - ophthalmic (V1), maxillary (V2) and mandibular (V3) - is implicated in BMS.
Objectives: To demonstrate the effectiveness of treatment with trigeminal rhizotomy in the V2 and V3 territories combined with sphenopalatine ganglion block in reducing chronic neuropathic pain in the oral cavity.
Case Report: Female patient, 55 years old, presented with a history of burning pain in the tongue and oral mucosa for two years. The pain occurred daily, lasting approximately 6 to 8 hours, without significant improvement with any medication. Clinical examination revealed no changes in the oral cavity. The patient underwent trigeminal rhizotomy in the V2 and V3 territories and sphenopalatine ganglion block, resulting in a 70% improvement in pain and an improvement in quality of life, which was maintained during six months of follow-up.
Conclusion: The combination of trigeminal rhizotomy in the V2 and V3 territories concurrently with sphenopalatine ganglion block appears to be effective in reducing chronic neuropathic pain in the oral cavity. Once other diseases of the oral mucosa related to mouth pain have been excluded and BMS has been diagnosed, the implemented therapy proves to be an effective approach in treating these patients refractory to drug treatment. Introdução: A Síndrome da Boca Ardente (SBA) é uma dor neuropática resultante de lesão ou patologia que afeta o sistema somatossensorial periférico ou central. Seus sintomas incluem queimação intraoral, e é importante descartar outras condições com manifestações semelhantes. Esta dor pode ser localizada na língua ou na ponta dela e pode estar relacionada à disestesia, disfunção do paladar e sensação de boca seca. Pode ser episódica ou contínua, com duração variável, tipicamente se assemelhando a um choque elétrico no primeiro caso e a uma sensação de queimação no segundo. Afeta predominantemente mulheres pós-menopáusicas, e estudos sugerem que a neuropatia sensorial das pequenas fibras do nervo trigêmeo - oftálmico (V1), maxilar (V2) e mandibular (V3) - está implicada na SBA.
Objetivos: Demonstrar a eficácia do tratamento com rizotomia trigeminal nos territórios V2 e V3, combinada com bloqueio do gânglio esfenopalatino, na redução da dor neuropática crônica na cavidade oral.
Relato de Caso: Paciente do sexo feminino, 55 anos, apresentou história de dor em queimação na língua e mucosa oral por dois anos. A dor ocorria diariamente, com duração de aproximadamente 6 a 8 horas, sem melhora significativa com qualquer medicação. O exame clínico não revelou alterações na cavidade oral. A paciente foi submetida à rizotomia trigeminal nos territórios V2 e V3 e bloqueio do gânglio esfenopalatino, resultando em uma melhora de 70% na dor e na qualidade de vida, que foi mantida durante seis meses de acompanhamento.
Conclusão: A combinação de rizotomia trigeminal nos territórios V2 e V3 concomitantemente com o bloqueio do gânglio esfenopalatino parece ser eficaz na redução da dor neuropática crônica na cavidade oral. Uma vez que outras doenças da mucosa oral relacionadas à dor na boca tenham sido excluídas e a SBA tenha sido diagnosticada, a terapia implementada demonstra ser uma abordagem eficaz no tratamento desses pacientes refratários ao tratamento medicamentoso.
Hipertensão intracraniana idiopática em paciente com história de enxaqueca: relato de caso
No full textIdiopathic Intracranial Hypertension in a Patient with a History of Migraine: A Case Report
GONÇALVES, Christian1; KUHN, Leonardo José1; DE LAZARI, Alan Henrique1; DE LAZARI, Kassia Beatriz Valério Saibert1; OLIVEIRA, Sara Pessoa de2; BARBOZA, Barbara Evelin Gonçalves3
1Academics of the Medicine Course at the Centro Universitário Integrado de Campo Mourão – PR
2 Physician, Neurologist, Master, Professor at the Centro Universitário Integrado de Campo Mourão - PR
3 Physician, Ophthalmologist, Professor at the Centro Universitário Integrado de Campo Mourão – PR
Contact with author: GONÇALVES, Christian Email: [email protected] Address: Av. Jorge Walter 1039, apt 02, Centro, Campo Mourão – PR – Brasil.
Introduction: Idiopathic intracranial hypertension (IIH) is a condition whose cause is not well understood, characterized by increased pressure within the skull without evidence of brain mass or hydrocephalus. It mainly affects women of childbearing age and is associated with obesity. Objective: Emphasize the importance of early diagnosis of IIH and the use of appropriate treatments. Case Report: 44-year-old woman with a long history of migraines with visual aura since menarche, characterized by intense unilateral pulsatile headache, accompanied by photophobia, phonophobia, osmophobia and occasionally nausea with vomiting. In the last three months before the consultation, there was an increase in the frequency of attacks, with pain occurring three times a week. His personal history includes congenital Dumping syndrome, history of smoking (29 years/pack) and presbyopia, initial weight of 76kg. After an initial period of treatment with topiramate and nortriptyline, which was effective, the patient showed a significant reduction in seizures. However, in January 2022, she was referred by an ophthalmologist due to bilateral papilledema, presenting atypical neurological symptoms such as retrocular pain, amaurosis fugax and holocranial headache. The initially normal imaging tests led to a lumbar puncture, which revealed elevated CSF pressure (32.5 cm of water), diagnosing idiopathic intracranial hypertension (IIH). Treatment was started with acetazolamide, resulting in partial improvement of headache symptoms, but with side effects such as nausea and tingling. The patient presented with a recurrence of symptoms in March 2023, after a stressful period at work, requiring acute treatment with prednisone. Over time, with adjustments in therapy and frequent monitoring, there was complete regression of papillary edema and partial resolution of visual symptoms, and the visual field was not damaged. Current weight of 70kg. Conclusion: This case highlights the challenges in diagnosing and managing IIH in patients with a prior history of migraine, emphasizing the need for a multidisciplinary and adaptive approach. Effective management required body weight control and medication adjustments to control neurological and ophthalmological symptoms leading to complete regression of papillary edema and the visual field was undamaged.
Keywords: Migraine with aura; Idiopathic intracranial hypertension; Papilledema
Individualized and structured guidance on sleep hygiene and water intake in migraine - partial analysis of results from the randomized clinical trial
Full text linkIntroduction: Migraine is a prevalent and debilitating primary headache disorder deeply influenced by lifestyle. Sleep disturbances are the second major trigger for migraine attacks, and some studies suggest that behavioral changes in sleep can reduce the intensity and frequency of headaches. Proper water intake is widely recommended; however, there is scant clinical evidence of the benefit of this intervention. Objective: To evaluate the effect of individualized and structured guidance on sleep hygiene and water intake on the disability and impact of migraine compared to the control group. Method: This study is a randomized, controlled, non-blinded clinical trial in which participants were randomly assigned to one of three groups: (1) control, (2) sleep hygiene, and (3) water intake. Individuals with migraine aged between 18 and 59 years, treated at the Academic Headache Clinic of PUCPR, Londrina-PR, Brazil, were included. The control group participants received usual care, the sleep hygiene group received individualized and structured guidance on sleep hygiene, and the water intake group received a 900ml water bottle and were instructed to drink three or more bottles per day. Participants were evaluated at baseline (T0) and after 12 weeks (T12) through a structured interview and self-administered questionnaires: Migraine Disability Assessment (MIDAS), Headache Impact Test 6 (HIT-6), Allodynia Symptom Checklist (ASC-12), Generalized Anxiety Disorder 7-item (GAD-7), Beck Depression Inventory (BDI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS). Results: Twenty-three participants completed 12 weeks of follow-up, with 8 in the control group, 6 in the water intake group, and 8 in the sleep hygiene group. The groups are comparable, with no differences in demographic and clinical characteristics (p>0.05). Within groups, there was an improvement in different parameters analyzed when comparing T0 and T12 (p<0.05). However, there was no better performance in the parameters evaluated when comparing the intervention groups with the control group, probably due to the small sample size so far. Conclusion: The results demonstrate that lifestyle interventions related to sleep and water intake are feasible in the context of medical care in a specialized outpatient clinic
RELAÇÃO ENTRE O EIXO INTESTINO-CÉREBRO E A MIGRÂNEA
No full textThe gut-brain axis and its role in migraine are increasingly recognized in the scientific community. This mini-review aims to explore the complex interaction between the gut microbiome and the central nervous system (CNS). The gut microbiota communicates bidirectionally with the brain through immune, endocrine, vagal, and other humoral pathways, influencing brain function and contributing to neuroinflammation and immune system disturbances. An imbalance in the gut microbiome can lead to systemic inflammatory responses, disrupted intestinal barrier integrity, and increased intestinal permeability, known as the "leaky gut syndrome." This condition is associated with a pro-inflammatory state that may trigger migraine attacks through the release of cytokines, activation of the trigeminovascular system, and modulation of pain processing pathways in the brain. Key components such as vagus nerve signaling, altered secretion of short-chain fatty acids (SCFAs), and neurotransmitter modulation play critical roles in this axis. The diet also significantly influences the microbiome, with high-fiber diets promoting anti-inflammatory SCFAs, while poor diets contribute to neuroinflammation and increased migraine susceptibility. Emerging evidence suggests that maintaining gut microbiome diversity and stability may alleviate migraine symptoms and enhance quality of life. This review highlights the importance of the gut-brain axis in migraine pathophysiology and suggests that targeting the microbiome could be an adjunctive therapeutic approach for migraine management.Evidências apontam que migranosos quando comparados com controles saudáveis, possuem alterações na quantidade e qualidade do microbioma intestinal, que perturbam a interação existente na conexão entre microbioma intestinal e sistema nervoso central (SNC), conhecida como “eixo intestino-cérebro”, predispondo a crises de migrânea. O presente artigo procura resumir evidências recentes sobre o eixo microbiota-intestino-cérebro na fisiopatologia da migrânea, destacando fatores que levam a pré-disposição para crises. Sugere-se que alterações na composição do microbioma intestinal, levam a formação de metabólitos citotóxicos, neuroinflamatórios e imunológicos, a permeabilidade intestinal e ao aumento de citocinas pró-inflamatórias (TNF-α, IL-1β e IL-6), que ativam o sistema trigemiovascular. Cepas bacterianas por geração de glutamato estariam envolvidas no estímulo desta mesma via. Lipopolissacarídeos (LPS) circulantes pelo comprometimento de barreira, associam-se a liberação do peptídeo relacionado ao gene da calcitonina (CGRP), e este ao exacerbamento da gravidade da condição álgica, por perpetuar alterações na composição do microbioma intestinal. Redução de bactérias produtoras de 5-HT e AGCC, seria outro fator relacionado, pois via nervo vago estas substâncias podem alterar a sinalização dopaminérgia e serotoninérgia, e no intestino reduzir hiperalgesia e liberação de TNFα e IL1-β. Tratamento com AGCC pode reduzir inflamação no intestino, resultando em efeito anti-inflamatório cerebral. A dieta é reconhecida como regulador chave da microbiota intestinal, a depender de sua composição modifica significativamente o microbioma, seu manejo pode contribuir como tratamento coadjuvante do eixo intestino-cérebro na migrânea
Characterization of facial pain in individuals with hemifacial spasm
Full text linkBackgroundHemifacial spasm (HFS) is defined by involuntary facial contractions, more common in women in the fifth decade of life. Facial pain associated with HFS is observed in clincal practice, although there is still little research on the subject. This study aims to investigate the frequency and characterization of facial pain in HFS patients and its correlations. ObjectiveCharacterize facial pain in HFS patients. Analyze if pain was associated with clinical spasm severity, quality of life (QoL), anxiety, depression and insomnia. MethodsCross-sectional study involving 59 patients of a public hospital. Patients with cognitive impairment, use of botulinum toxin in the last three months and other movement disorders were excluded. Data were obtained using the following instruments: sociodemographic questionnaire; structured questionnaire of facial pain characteristics (intensity in a visual analog scale: VAS, frequency, location); McGill pain questionnaire; hemifacial spasm grading questionnaire (HFS-Score) for clinical severity and QoL; hospital anxiety and depression scale (HADS); and insomnia severity index (ISI).ResultsAmong 59 patients, 39 (66.1%) were female and mean age was 65.9 years (SD: 12.9). Average diagnosis time was 15.5 years (SD: 8.5) and most common spasm side was left: 36 patients (61%). 26 patients (44.1%) reported facial pain, mean intensity was 6.1 (SD: 2) in VAS and frequency of 5 (IQR: 12) days/month. The facial pain locations were: periorbital in 21 cases (80.7%), maxillary in 5 (19.2%) and mandibular in 2 (7.6%). Auricular and whole hemiface were mentioned in 1 case (3.8%) each. 25 patients (96.1%) described pain ipsilaterally to spasm, and 1 (3.9%) described pain bilaterally. Most common descriptors for pain were: pulling (11 patients), itchy (10 patients) and annoying (10 patients). Association between facial pain and worse QoL was found (p: 0.038; Mann-Whitney test). Facial pain was related to insomnia (p: 0.037; Fisher exact test). No association was found between facial pain and clinical spasm severity, age, anxiety or depression. ConclusionThis study showed a considerable frequency of facial pain in HFS patients and characterized its patterns and correlations. Explore pain symptoms in HFS patients is necessary for tailored therapeutic approaches