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No full textBackground
Migraine constitutes a major public health concern since it negatively affects both the quality of life and the productivity of patients. Migraine among students can cause impaired academic performance and limit their daily activities.
Objective
This study aims to assess the prevalence of migraine among university students using the ID Migraine screening tool and to evaluate risk factors associated with migraine.
Methods
A cross-sectional study was performed over a period of six months targeting 1144 university students recruited from the different faculties.
Results
Migraine was suggested in 35.8% of subjects based on ID-Migraine. Migraine prevalence was significantly higher among women (42% versus 23.3% of men). After adjusting for covariates, women, daily coffee consumption, having unorganized meals, eating fast food and fasting were the main predictors of migraine. Almost 41% of migraine students had a family history of migraine and only 26.7% sought medical help. Interestingly, most of the migraine students (84.8%) took headache medications without referring them to their doctor.
Conclusion
Recognizing headache risk factors among migraine students and adopting lifestyle changes accordingly can be an effective strategy to prevent the chronification of the attacks, decrease headache frequency and improve patients’ quality of life
Prevalência de depressão pós-parto em pacientes migranosas
No full textIntroduction
Migraine is a frequent and chronic condition that affects 3 times more women than men. Overall, it shows that migraine is influenced by variables such as fluctuating hormones levels throughout life with migraine. Women can also experience symptoms of postpartum depression (PPD) which can cause issues for new moms in terms of behavior, emotion and cognition. Clinical investigations have shown that headaches affects pregnants and parturients.
Objective
To verify PPD in migraine and non-migrainous parturients.
Methods
Data was collected from a sample of 155 women over 18 years old in the obstetric center of Santa Casa de Misericórdia de Barbacena, from October 2021 to August 2022, in the first 24 hours after labor. Parturients who did not agree to participate and those with cognitive impairment were excluded. All patients signed an informed consent form and answered the Edinburgh Postnatal Depression Scale (EPDS) and the ID-MigraineTM, in addition to clinic data and concomitant disorders from the patient\u27s record.
Results
25 of the 155 postpartum women achieved the criteria for migraine and 130 for non-migraine. Of the patients with postpartum depression associated with migraine, 4 were classified as migraine and 8 as non-migrainous. Among patients who had headaches during pregnancy, 11 had PPD compared to those who did not have headaches during pregnancy: 1. The OR=8.9 (CI 1.12-70) and RR=7.9 (CI 1.05-60) were higher compared to those who did not have PPD. The analysis did not find a relation between migraine and PPD. However, a relation was found between headaches during pregnancy and the presence of PPD (p<0.05).
Conclusion
Patients who experienced headaches while pregnant are more likely to have postpartum depression. However, migraine-diagnosed puerperal women do not present considerable concerns for the development of depression.Introdução: A enxaqueca é um distúrbio frequente e crônico que afeta três vezes mais mulheres do que homens. No geral, sabe-se que a enxaqueca é influenciada por variáveis como níveis hormonais flutuantes ao longo da vida com enxaqueca. As mulheres também podem apresentar sintomas de depressão pós-parto (DPP), que podem causar problemas para as novas mães em termos de comportamento, emoção e cognição. Investigações clínicas mostraram que as dores de cabeça afetam gestantes e parturientes. Objetivo: Verificar a DPP em parturientes migranosas e não migranosas. Métodos: Os dados foram coletados de uma amostra de 155 mulheres, maiores de idade, no centro obstétrico da Santa Casa de Misericórdia de Barbacena, entre outubro de 2021 e agosto de 2022, nas primeiras 24 horas após o parto. Foram excluídas as parturientes que não concordaram em participar e aquelas com comprometimento cognitivo. Todos os pacientes assinaram um termo de consentimento informado e responderam à Escala de Depressão Pós-natal de Edimburgo (EPDS) e ao ID-MigraineTM, além de dados clínicos e distúrbios concomitantes do prontuário da paciente. Resultados: 25 das 155 puérperas atingiram os critérios para enxaqueca e 130 para não enxaquecosa. Das pacientes com depressão pós-parto associada à enxaqueca, 4 foram classificadas como enxaquecosas e 8 como não enxaquecosas. Entre as pacientes que tiveram cefaleia durante a gravidez, 11 tiveram DPP em comparação com aquelas que não tiveram cefaleia durante a gravidez: 1. OR=8,9 (IC 1,12-70) e RR=7,9 (IC 1,05-60) foram maiores em comparação com aquelas que não tinham DPP. A análise não encontrou relação entre enxaqueca e DPP. No entanto, houve relação entre cefaleia na gestação e presença de DPP (p<0,05). Conclusão: Gestantes que tiveram dores de cabeça são mais propensas a ter depressão pós-parto. No entanto, puérperas migranosas não apresentam riscos para o desenvolvimento de depressão
Headache frequency among 71,267 admissions to an adult medical emergency in the city of Recife in 2021
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Pain is a warning sign that can mean great suffering and risk of death, and makes the patient seek a medical emergency for evaluation by specialists.
Objective
To verify the frequency of patients with headache disorders among those with pain admitted to the emergency department of a private hospital in Recife, Brazil, during the year 2021, using the international classification of diseases (ICD).
Methods
This is a retrospective study. The authors used the Business Intelligence (BI) tool to verify the number of admission by the ICD 10 recorded in 2021 in the emergency room of Hospital Unimed Recife III. The sample described in this study covers only the ICDs that had the word DOR (pain in Portuguese) or pain be the main symptom of the condition represented by the respective ICD. We selected only ICDs used in at least five admissions in 2021 (January to December), independent of readmission of the same patient.
Results
There were 71,267 consultations in 2021 using 2,296 different ICDs. Of these, the Headache (CEFALEIA) ICD was the 7th most frequent (n= 2,121) behind the following ICDs: Unspecified viral infection (n= 4,327); Influenza with other respiratory manifestations, due to unidentified virus (n= 3,335); Respiratory infection by the new coronavirus (Covid-19) (n= 2,927); Low back pain (n=2,759) and Diarrhea and gastroenteritis of presumptive infectious origin (n=2,739). In 27,853/71,267 (39.1%), the consultations were related to pain in any part of the body (with 258 ICDs). In the group of patients with pain of traumatological, orthopedic, or rheumatic origin, there were 10,148 consultations (142 ICDs); Abdominal or pelvic pain (5,675, with 23 DICs); Spinal pain (3,805, with 10 ICDs); and Chest pain, including coronary ischemia (1,786, with 10 ICDs)...
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Cefaléia por diálise: uma revisão da literatura nos últimos 30 anos
No full textIntroduction
According to the International Classification of Headache Disorders (ICHD-3), dialysis headache has no specific characteristics occurring during and caused by haemodialysis. It resolves spontaneously within 72 hours after the haemodialysis session has ended.
Objective
To describe the prevalence, clinical features, associated symptoms and risk factors of dialysis headache.
Methods
Based on a literature search in the major medical databases and using the descriptors“dialysis headache”, “hemodialysis and headache” and “renal dialysis and headache”we included articles published between 1992 and 2022. Of the 492articles found, only 9 met the inclusion criteria and were analyzed.
Results
We describe 444 patients (53.1% men and 46.9% women) diagnosed with dialysis headache, corresponding to 24.8% of those who underwent hemodialysis.The age ranged from 15 to 75 years. Pain occurred predominantly from the third hour of hemodialysis (65.8%), lasting less than four hours (71.7%), located bilaterally (63.1%), pulsatile (58.5%) and moderate intensity (68.9%).The most frequent associated symptoms were photophobia or phonophobia (71.5%), vertigo (22.3%) and nausea and/or vomiting (16.5%).
Conclusion
This review showed a high prevalence of dialysis headache in patients undergoing hemodialysis and that the clinical characteristics, treatment and prevention are still poorly studied.Introdução
De acordo com a Classificação Internacional de Cefaleias (ICHD-3), a cefaleia da diálise não tem características específicas ocorrendo durante e causada pela hemodiálise. Resolve-se espontaneamente em até 72 horas após o término da sessão de hemodiálise.
Objetivo
Descrever a prevalência, características clínicas, sintomas associados e fatores de risco de cefaléia por diálise.
Métodos
Com base em uma pesquisa bibliográfica nas principais bases de dados médicas e usando os descritores “dialysis pain”, “hemodiálise e dor de cabeça” e “renal diálise e dor de cabeça”, incluímos artigos publicados entre 1992 e 2022. Dos 492 artigos encontrados, apenas 9 atenderam à inclusão critérios e foram analisados.
Resultados
Descrevemos 444 pacientes (53,1% homens e 46,9% mulheres) diagnosticados com cefaléia dialítica, correspondendo a 24,8% daqueles que realizaram hemodiálise. A idade variou de 15 a 75 anos. A dor ocorreu predominantemente a partir da terceira hora de hemodiálise (65,8%), com duração inferior a quatro horas (71,7%), localizada bilateralmente (63,1%), pulsátil (58,5%) e de intensidade moderada (68,9%). fotofobia ou fonofobia (71,5%), vertigem (22,3%) e náusea e/ou vômito (16,5%).
Conclusão
Esta revisão mostrou alta prevalência de cefaléia dialítica em pacientes em hemodiálise e que as características clínicas, tratamento e prevenção ainda são pouco estudadas
Case report: a paroxysmal hemicrania responsive to verapamil
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Paroxysmal hemicrania (PH), a trigeminal autonomic headache, is characterized by unilateral pain in the orbital, supraorbital, and temporal regions, accompanied by nasal congestion and ocular hyperemia, with a predominance (not exclusively) in women, with attacks lasting 2 to 30 minutes and occurring several times daily. Pain crises have been known to cease completely or almost completely with the use of indomethacin. However, in some patients, the side effects caused by taking the drug prevent continuation of treatment. There is also the possibility of a partial response to the first-line drug. In these cases, alternative drugs are chosen, with verapamil being one of the drugs of choice.
Objectives
In this report, we present a case of a patient with a partial response to the first-line drug therapy and good responsiveness to verapamil.
Methods
We collected patient data through the electronic medical record. Afterward, we reviewed the literature regarding paroxysmal hemicrania and its responsiveness to indomethacin and verapamil.
Results
A 56-year-old woman presented with a 1-year history of throbbing pain in the left hemiface, and retro-orbital and temporal ipsilateral pain, lasting approximately 30 minutes with a frequency of 5-6 episodes per day and a maximum remission period of 3 months. The headache attacks were associated with nasal congestion and allodynia and had worsened recently. Her medical history was positive for major depressive disorder and hypertension. At the time she presented, she was taking carbamazepine 900 mg per day, which resulted in partial relief of pain. Clinical examination revealed pain on palpation of the trigeminal branches on the left side, bilateral temporomandibular pain, and pain on palpation of the right greater occipital nerve. Magnetic resonance angiography of the head showed no abnormalities...
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Executive and attentional functions in patients with migraine
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The Executive Functions (EF) allow the individual to direct behaviors to the goal, evaluate his/her efficiency and appropriateness, and eliminate ineffective strategies by other efficient and functional ones to solve short, medium, and long-term problems. To this end, attention is fundamental to learning and problem solving.
Objective
To relate executive and attentional functions with the presence or absence of migraine.
Methods
A cross-sectional study on the presence of attentional and EF alterations in migrant patients, with a target sample of 42 subjects, 30 migrants and 13 non-migrants. Subjects above eighteen (18) years of age, recruited consecutively by convenience at the Centro Acadêmico Multiprofissional Dr. Agostinho Paolucci of the Faculdade de Medicina de Barbacena - CAM FAME, Faculdade de Medicina and Centro AMA de Desenvolvimento, were included in the study, regardless of sex, after completion of the free and informed consent form - FICF. Subjects with migraine were in accordance with the criteria of the International Classification of Headaches (ICHD-3). All subjects diagnosed with migraine and undergoing neuropsychological evaluation were included. The Psychological Attention Assessment Battery (APB) was used for the attention test and the Five Digits Test was used for the EF test. The APB measures the attentional performance in 3 (three) distinct types of attention, related to 1) the ability to maintain the focus of attention on a given stimulus for a prolonged time; 2) the ability to distribute attention resources for the simultaneous execution of multiple tasks; 3) the ability to alternate attention resources among different stimuli. The Five Digits Test verifies the speed of reasoning and response, its accuracy and assertiveness, and can also be used as a measure of attentional processes and their accuracy.
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Relato de caso de neuropatia oftalmoplégica dolorosa recorrente
No full textRecurrent Painful Ophthalmoplegic Neuropathy (RPON) is a rare condition, previously known as Ophthalmoplegic Migraine, it is characterized by headache ipsilateral to paresis of the III, IV or VI cranial nerve, usually affects children or young adults. This is a report of a case of RPON in a 16-year-old woman treated at the Hospital do Servidor Público Estadual de São Paulo.A Neuropatia Oftalmoplégica Dolorosa Recorrente (ONRP) é uma condição rara, anteriormente conhecida como Enxaqueca Oftalmoplégica, caracteriza-se por cefaléia ipsilateral à paresia do III, IV ou VI nervo craniano, geralmente acomete crianças ou adultos jovens. Este é um relato de caso de RPON em uma jovem de 16 anos atendida no Hospital do Servidor Público Estadual de São Paulo
Headache-related cognitive distortions questionnaire
Get PDFBackground. - Cognitive distortions are systematic errors in thinking and can be observed in the relationship of headache patients with their own disease and treatment.
Objective. - To construct and validate an instrument to evaluate headache-related cognitive distortions in those with primary headache disorders; and to investigate the psychometric properties of this new instrument. Methods. - One hundred thirty-six (136) migraine outpatients from three Brazilian specialized headache hospital services completed the Headache-related Cognitive Distortions Inventory (HCDQ) and validated measures of psychological symptoms, pain catastrophizing, mood disorders, quality of life and headache-related disability. Results. - All hypothesized study measures’ correlations were statistically significant, supporting construct validity. HCDQ scores were positively correlated with headache frequency, headache intensity, psychological symptoms, depression, anxiety, and pain catastrophizing; and negatively correlated with 7 of 8 quality of life domains and time the patient was in treatment. Cronbach’s alpha demonstrated excellent internal consistency for the 17-item total scale (alpha=.92). Along with headache intensity and depression, HCDQ Pain subscale accounted for 46% of variance in the prediction of headache-related disability. Conclusions. - HCDQ is a valid and reliable measure of migraine patients´ cognitive distortions about their headaches and headache treatment
Relationship between cutaneous allodynia, cervical muscle strength and endurance in women with migraine
Get PDFIntroductionMigraine is a primary headache disorder with generalized neuronal hyperexcitability. Migraine individuals have a high prevalence of cutaneous allodynia, neck pain, and reduced cervical isometric strength. Lower isometric strength is also known to correlate with greater severity of cutaneous allodynia. However, the correlation between cervical muscle endurance and cutaneous allodynia is not yet known.
ObjectiveTo evaluate the correlation between cervical muscle strength and endurance with cutaneous allodynia in migraine women.
MethodsSeventy migraine women were recruited by local community advertisements. Were included women aged between 18 and 55 years and migraine diagnosis. An experienced neurologist diagnosed potential participants with migraine according to the third edition of the International Classification of Headache Disorders (ICHD-3). Participants were excluded if they underwent an anesthetic nerve block; presented with any other concomitant headache, such as cervicogenic or tension-type headache, degenerative cervical conditions, or history of trauma at the neck and face, or pregnancy.The Multi Cervical Rehabilitation Unit (MCU) was used to assess cervical isometric muscle strength and cervical muscle endurance. The assessment of cervical isometric strength was obtained through three repetitions of the movement in flexion, extension, and lateral flexion. The endurance of cervical flexors and extensors muscles was obtained using 50% of the maximum voluntary isometric contraction. The MCU is a device with excellent reliability (ICC 0.92–0.99) for assessing cervical muscle strength and endurance.Cutaneous allodynia was evaluated using the Allodynia Symptom Checklist (ASC-12), a reliable, quick, and simple tool with excellent psychometric properties, compound of 12 questions that allows to classify the severity of cutaneous allodynia. The questionnaire was validated for the Portuguese language and it is able to diagnose and classify allodynia in the Brazilian population, in order to facilitate the identification of symptoms in a reliable and fast manner (ASC-12).
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Incorporação de tecnologias em saúde: a importância do tratamento medicamentoso das cefaleias primárias no sistema único de saúde brasileiro
No full textIncorporation of health technologies: The importance of drug treatment of primary headaches in the Brazilian unified health systemIncorporação de tecnologias em saúde: a importância do tratamento medicamentoso das cefaleias primárias no sistema único de saúde brasileir