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Addressing sick building syndrome and its connection to headache disorders
Full text linkIntroduction
Sick Building Syndrome (SBS), a term introduced by the World Health Organization in 1983, refers to the occurrence of acute health and comfort issues in individuals occupying specific indoor environments without an identifiable clinical cause. Among the most commonly reported symptoms are headaches, particularly migraines and tension-type headaches, which significantly affect daily functioning and workplace productivity.
Review
This review examines the primary environmental, chemical, biological, and psychosocial factors contributing to SBS and their influence on the onset and exacerbation of headaches. Poor indoor air quality, inadequate ventilation, and elevated carbon dioxide (CO₂) levels are identified as major physical factors. CO₂ concentrations above 1000 ppm are associated with impaired cognitive function, cerebral vasodilation, and the onset of headaches. Exposure to volatile organic compounds from office materials and cleaning agents, as well as biological contaminants such as mold and dust mites and electromagnetic radiation, is also implicated. In parallel, psychosocial elements such as occupational stress, poor ergonomics, and limited access to natural light exacerbate headache symptoms. The cumulative effect of these stressors contributes not only to physical discomfort but also to decreased performance and increased presenteeism. Preventive measures include improving ventilation systems, implementing green building practices, regulating humidity levels, implementing ergonomic interventions, and promoting mental well-being in the workplace.
Conclusions
SBS is a complex occupational health issue strongly associated with headache disorders. Addressing its multifactorial causes through integrated environmental and organizational strategies is essential for enhancing employee health, reducing headache incidence, and improving productivity. Tackling SBS represents both a health imperative and a strategic investment in workplace sustainability
Hiperacusia e níveis plasmáticos de citocinas na enxaqueca
No full textIntroductionMigraine is a chronic pain that represents a public health problem and compromises quality of life, with an inflammatory factor involved in its pathophysiology.ObjectiveTo verify whether there is an increase in serum cytokines in patients with migraine associated with hyperacusis.MethodsThe sample consisted of 80 participants in the episodic and/or chronic migraine group, with/without aura, and 80 healthy individuals; aged 18 to 60 years of both sexes. Instruments used: ID-migraine, Migraine Disability Assessment (MIDAS); Short-Form Headache Impact Test (HIT-6), State Trait Anxiety Inventory (STAI) Y1 Y2, Beck Inventory, Allodynia and Hyperacusis Questionnaire; interleukin dosage by flow cytometry.ResultsThe sample was homogeneous for sex, age and race (p>0.05). There was an association between hyperacusis and migraine (p<0.001). 41.2% of patients with migraine had hyperacusis. The majority of the population with migraine had phonophobia (87.8%); photophobia (93.7%); osmophobia (61.5%); episodic migraine (65.4%); prodrome and postdrome in 80% of them; half of them did not have aura (52%) or allodynia (53.2%). Regarding serum cytokine levels, they had higher levels of IL-2 and TNF-α (Mann-Whitney, p<0.001). INF-γ, IL-4, IL-6, IL-10 in plasma did not differ statistically between the control and migraine groups (Mann-Whitney, p>0.05). The association of hyperacusis with cytokines IL-2, IL-4 and TNFA (Mann-Whitney, p>0.05) in migraine patients was observed.ConclusionIt was possible to verify that there was a significant difference in plasma cytokine levels between the groups. The increase in inflammatory markers indicates the possibility of complementary treatment, allowing the intervention of other professionals from multi and interdisciplinary teams.IntroduçãoA enxaqueca é uma dor crônica que representa um problema de saúde pública e compromete a qualidade de vida, com fator inflamatório envolvido em sua fisiopatologia.ObjetivoVerificar se há aumento de citocinas séricas em pacientes com enxaqueca associada à hiperacusia.MétodosA amostra foi composta por 80 participantes do grupo enxaqueca episódica e/ou crônica, com/sem aura, e 80 indivíduos saudáveis; com idade entre 18 e 60 anos, de ambos os sexos. Instrumentos utilizados: ID-migraine, Migraine Disability Assessment (MIDAS); Short-Form Headache Impact Test (HIT-6), State Trait Anxiety Inventory (STAI) Y1 Y2, Beck Inventory, Allodynia and Hyperacusis Questionnaire; dosagem de interleucina por citometria de fluxo.ResultadosA amostra foi homogênea quanto ao sexo, idade e raça (p>0,05). Houve associação entre hiperacusia e enxaqueca (p<0,001). 41,2% dos pacientes com enxaqueca apresentaram hiperacusia. A maioria da população com enxaqueca apresentou fonofobia (87,8%); fotofobia (93,7%); osmofobia (61,5%); enxaqueca episódica (65,4%); pródromo e pós-dromo em 80% deles; metade deles não apresentou aura (52%) ou alodínia (53,2%). Em relação aos níveis séricos de citocinas, eles apresentaram níveis mais elevados de IL-2 e TNF-α (Mann-Whitney, p<0,001). INF-γ, IL-4, IL-6, IL-10 no plasma não diferiram estatisticamente entre os grupos controle e enxaqueca (Mann-Whitney, p>0,05). Foi observada a associação da hiperacusia com as citocinas IL-2, IL-4 e TNFA (Mann-Whitney, p>0,05) em pacientes com enxaqueca.ConclusãoFoi possível verificar que houve diferença significativa nos níveis plasmáticos de citocinas entre os grupos. O aumento dos marcadores inflamatórios indica a possibilidade de tratamento complementar, permitindo a intervenção de outros profissionais de equipes multi e interdisciplinares
Prevention of migraine in children and adolescents: results of an open-label study with special extract of Petasites hybridus root
Full text linkIntroduction
Migraine is a genetic disease that has a major impact on life. Its prevalence is estimated to be 7.7% up to the age of 20. Preventive treatment of migraine in childhood and adolescence remains a challenge, due to the few studies conducted for this population and the presence of side effects in the use of the medications used.
Method
In this article, we evaluated the prospective open study conducted by Pothmann and Danesch using Petasites hybridus extract as a preventive treatment for migraine in children (6-9 years) and adolescents (10-17 years).
Results
This open study showed that at the end of the 4 months of treatment with Petasites hydbridus the reduction in migraine attacks in the total sample was 63.2%, 67% for children aged 6 to 9 years and 61.9% for adolescents aged 10 to 17 years. The overall response rate was 77.2%, with 85.7% for the 6- to 9-year-old group and 74.1% for the 10- to 17-year-old group. There was also a reduction in the mean duration of attacks in 62.7% of patients, from approximately 10 hours to 7 hours. No significant side effects were observed.
Conclusion
Petasites hybridus proved to be a safe and effective option for the preventive treatment of migraine in children and adolescents.A migrânea é uma doença genética que gera um grande impacto durante a vida. Estima-se que sua prevalência até os 20 anos de idade seja de 7.7%. O tratamento preventivo da migrânea na infância e adolescência permanece um desafio, pelo fato de termos poucos estudos realizados para esta população e pela presença de efeitos colaterais no uso dos medicamentos empregados. Neste artigo avaliamos o estudo aberto prospectivo realizado por Pothmann e Danesch empregando extrato de Petasites hybridus como preventivo no tratamento da migrânea em crianças (6-9 anos) e adolescentes (10-17 anos) que mostrou ao final dos 4 meses de tratamento uma redução das crises na amostra total foi de 63,2%, sendo 67% para crianças de 6 a 9 anos e 61,9% para adolescentes de 10 a 17 anos. A taxa de resposta global foi de 77,2%, com 85,7% para o grupo de 6 a 9 anos e 74,1% para o grupo de 10 a 17 anos. Houve também redução na duração média das crises em 62,7% dos pacientes, passando de cerca de 10 horas para 7 horas.
O uso de Petasites hybridus no tratamento preventivo da migrânea em crianças e adolescentes se mostrou eficaz e seguro, devendo ser considerado como uma opção no arsenal terapeutico da migranea em crianças e adolescente
Neuralgia do trigêmeo em pacientes com esclerose múltipla: uma revisão sistemática e meta-análise de procedimentos cirúrgicos minimamente invasivos, descompressão e resultados relacionados à dor.
No full textBackgroundTrigeminal neuralgia is characterized by episodes of severe, recurrent, anddebilitating facial pain that can occur in 1 to 2% of the patients who are diagnosedwith multiple sclerosis throughout their lives. Trigeminal neuralgia can be describedas ranges of intense facial pain, like electric shocks, involving the trigeminal nerve.The aim is to demonstrate the effectiveness of various minimally invasive proceduresfor controlling trigeminal neuralgia pain in patients with multiple sclerosis, rangingfrom conservative to surgical treatment.MethodsThe review focused on surgical clinical outcomes and treatment modalities relatedto trigeminal neuralgia in patients with multiple sclerosis treated with MISS, stemcells as a modern treatment. The comprehensive search was conducted in severaldatabases, including ScienceDirect, PubMed/MEDLINE, Google scholar, and theEMBASE Database, of systematic review using the PRISMA guidelines, R software,and Excel. PROSPERO ID: 1173874 terms, only studies published in English up toJanuary 1987 and September 2025.ResultsIn our systematic review and meta-analysis, we included a total of N=1559 patientswith trigeminal neuralgia caused by multiple sclerosis. These were broken down intoN=836 patients, or 53%. Among these, N=867 procedures accounted for 55% ofthe total. Ch2 192-193.34, df=13, p < .010000.ConclusionTrigeminal neuralgia, which can be caused by multiple sclerosis, is a doublecombination to the patient\u27s pain. The most common treatments are percutaneousrhizotomies, including radiofrequency rhizotomy, glycerol rhizotomy, andpercutaneous balloon compression, and anatomical microvascular decompressionand treatment therapy on stem cells.ContextoA neuralgia do trigêmeo (NT) é caracterizada por episódios de dor facial intensa, recorrente e debilitante, que podem ocorrer em 1 a 2% dos pacientes diagnosticados com esclerose múltipla ao longo da vida. A neuralgia do trigêmeo pode ser descrita como uma série de dores faciais intensas, semelhantes a choques elétricos, envolvendo o nervo trigêmeo. O objetivo desta revisão é demonstrar a eficácia de diversos procedimentos minimamente invasivos para o controle da dor da neuralgia do trigêmeo em pacientes com esclerose múltipla, desde o tratamento conservador até o cirúrgico.
MétodosEsta revisão concentrou-se nos resultados clínicos cirúrgicos e nas modalidades de tratamento relacionadas à neuralgia do trigêmeo em pacientes com esclerose múltipla tratados com terapia minimamente invasiva com células-tronco, uma abordagem moderna para o tratamento. A busca abrangente foi realizada em diversas bases de dados, incluindo ScienceDirect, PubMed/MEDLINE, Google Scholar e EMBASE, utilizando as diretrizes PRISMA, o software R e o Excel. ID PROSPERO: 1173874. Termos: somente estudos publicados em inglês entre janeiro de 1987 e setembro de 2025.
ResultadosEm nossa revisão sistemática e meta-análise, incluímos um total de N=1559 pacientes com neuralgia do trigêmeo causada por esclerose múltipla. Destes, N=836 pacientes (53%) foram submetidos a procedimentos, representando 55% do total. Ch2 192-193.34, df=13, p < 0,010000.
ConclusãoA neuralgia do trigêmeo, que pode ser causada por esclerose múltipla, representa uma dupla consequência para a dor do paciente. Os tratamentos mais comuns são rizotomias percutâneas, incluindo rizotomia por radiofrequência (RFR), rizotomia com glicerol (GR) e compressão percutânea com balão (PBC), além de descompressão microvascular anatômica e terapia com células-tronco
Petasites hybridus: evidence 1A on migraine prophylaxis
Full text linkPetasites hybridus extract is part of the therapeutic arsenal for migraine prophylaxis. In this commentary, we discuss the study by Lipton et al. (2004), published in Neurology, which presents a high-quality clinical trial demonstrating the efficacy of Petasites hybridus for migraine prevention. The study, conducted by renowned researchers, classifies Petasites hybridus as a Level A treatment (established efficacy based on >2 Class I trials). Despite this strong evidence, questions often arise regarding the appropriate clinical scenarios for prescribing this medication. In addition to analyzing the findings of this seminal study, this commentary explores potential indications for Petasites hybridus in clinical practice
Descriptive epidemiological study of migraine in three emergency departments of the public health network of Chile
Full text linkBackground
Migraine is a prevalent neurological disorder with a significant impact on public health. This study aims to describe the epidemiological profile of migraine cases treated in three public emergency departments in Chile.
Methods
A descriptive epidemiological study was conducted using data from patients diagnosed with migraine in three emergency departments. Patient demographics, clinical presentation, and treatment approaches were analyzed.
Results
During the study period, 199,263 patients were seen across three hospitals. Migraine consultations accounted for 1.47% of visits, with 1.65% at HLF, 1.2% at HFB, and 1.58% at HCM. The majority of cases were in women at HLF and HFB, while men represented 71.6% of cases at HCM. The highest frequency of cases was observed in the active age groups.
Conclusions
This study highlights the burden of migraine in public emergency departments in Chile. The findings emphasize the need for optimized treatment protocols and preventive strategies to improve patient outcomes
O Comitê de Fisioterapia da Sociedade Brasileira de Cefaleias está representado no Grupo Especial de Interesse em Fisioterapia
No full textJournal Citation Reports 2025: the international landscape of headache journals and the path of Headache Medicine
Full text linkMedication overuse headache: a pragmatic 5-year, real-world study
Full text linkBackground
Medication overuse headache (MOH) impacts 1-7% worldwide. Effective treatment involves the abrupt discontinuation of the overused medication, the implementation of transition therapy during the initial period, and the simultaneous commencement of preventive treatment.
Objective
To describe a 5-year follow-up of patients with chronic migraine and MOH, focusing on the effectiveness of withdrawal treatment, use of traditional preventive medication, and requirement of anti-CGRP monoclonal antibodies.
Method
A single-center, prospective, and descriptive study was conducted. Convenience sampling of consecutive patients diagnosed with chronic migraine and MOH was the inclusion criterion. Demographics and clinical data at baseline, at 12 months, and during a follow-up period of 5 years, were collected in clinical records. The statistical analyses were performed with the Statistical Package for Social Sciences (SPSS®) version 18.2.2.
Results
We were able to follow one hundred and forty patients (116 W, 26 M), ages 18-78 years (mean 42.1±14.3) for 5 years. The diagnosis was carried out 24.9±14.7 years after the onset of the headache, and 6.3±7.6 years, was the time with headache ≥15 days per month. On baseline, the average number of headache days per month (HDM) was 25.2±5.9. There was a meaningful reduction in HDM. At 1 year and 5 years, a ≥ 75% reduction in HDM was observed, respectively, in 51.4% and 70.4% of the sample.
Conclusions
After five years, patients with chronic migraine and MOH who withdrew from excessive medication, used preventive pharmacological agents, and optionally added anti-CGRP monoclonal antibody showed a significant decrease in HDM frequency
