Fibromigraine: a cohort study retrospective / Fibroenxaqueca: um estudo de coorte retrospectivo

OBJECTIVE: To diagnose fibromyalgia in patients with migraine and assess the quality of life of these patients. METHODS: A 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). RESULTS: We 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). CONCLUSIONS: Patients with migraine are more predisposed to depression when there is an association with fibromyalgia

OBJETIVO: Diagnosticar fibromialgia em pacientes com enxaqueca e avaliar a qualidade de vida desses pacientes. MÉTODOS: Foi realizado um estudo prospectivo, transversal, comparando grupos, em uma amostra não randomizada, composta por pacientes com diagnóstico de enxaqueca. A amostra foi avaliada por meio dos questionários Widespread Pain Index (WPI) e Symptom Severity Scale (SSS) para diagnóstico de fibromialgia. A qualidade de vida e o nível de depressão foram avaliados, respectivamente, por meio do Headache Impact Test-6 (HIT-6) e do Patient Health Questionnaire-9 (PHQ-9). RESULTADOS: Foram entrevistados 100 pacientes (5 homens e 95 mulheres) com diagnóstico de enxaqueca, com idade média de 37,1±11,0 anos, variando de 19 a 64 anos. Trinta e quatro pacientes (34%) apresentavam enxaqueca e fibromialgia concomitantemente. A enxaqueca predominou no sexo feminino, tanto na presença como na ausência de fibromialgia. Em ambos os grupos, não houve diferença nas características da dor de cabeça. No grupo com fibromialgia houve predomínio de alodinia e maior escore no PHQ-9 (p<0,001). CONCLUSÕES: Pacientes com enxaqueca estão mais predispostos à depressão quando há associação com fibromialgia

"Growing pains" in children and adolescents as an early symptom of migraine: A prospective study.

BACKGROUND: Children and adolescents may experience pain in the lower limbs, predominantly at the end of the day or during the night, without any relation to organic disease. These pains are often called "growing pains" (GP) by pediatricians and orthopedists. They are commonly attributed to rapid growth. OBJECTIVE: The aim of this study was to review and characterize GP in children and adolescents as a precursor/comorbidity with migraine. METHODS: The study was of a cross-sectional, prospective, longitudinal cohort, with group comparison. A sample of 100 children/adolescents born to mothers with migraine seen at a headache clinic was recruited in a random order chosen by lot, maintaining the ratio of 1:1 for the group with GP and the controls. Both groups were followed for a period of 5 years. RESULTS: After 5 years of follow-up, 78 patients completed the study, of which 42 were from the GP group and 36 were from the control group. Headache fulfilling the International Classification of Headache Disorders, 3rd edition diagnostic criteria for migraine without aura or probable migraine occurred in 32/42 (76%) of patients with GP and in 8/36 (22%) of controls (p < 0.001). In the sample that initially had "growing pains," these pains persisted in 6/42 (14%) and appeared in 14/36 (39%) of those who were previously asymptomatic (p = 0.026). CONCLUSIONS: Pain in the lower limbs of children and adolescents, commonly referred to as GP by pediatricians and orthopedists, may reflect a precursor or comorbidity with migraine.

Why does ingestion of watermelon trigger headache attacks in patients with migraine? / Por que a ingestão de melancia desencadeia crises de dor de cabeça em pacientes com enxaqueca?

Several triggers can trigger a migraine attack, including food. By the way, food only triggers headache in migraine sufferers. The foods that most trigger headache attacks are these: cheese, chocolate, citrus fruits and some sweet fruits, such as watermelon.

Vários gatilhos podem desencadear uma crise de enxaqueca, incluindo alimentos. Aliás, a comida só provoca dor de cabeça em quem sofre de enxaqueca. Os alimentos que mais desencadeiam as crises de dor de cabeça são estes: queijo, chocolate, frutas cítricas e algumas frutas doces, como a melancia.

Propranolol: A migraine prophylactic since the 1960s / Propranolol: um profilático para enxaqueca desde 1960

Introduction: Propranolol was the first non-selective beta-adrenergic blocker to be developed. Initially it was used in the treatment of cardiovascular diseases, but since the 60's it has been used in the prevention of migraine. Objective: The objective of this study was to know the history of propranolol and its use as a migraine prophylactic. Methods: This study was an integrative literature review using articles with historical data on propranolol, from its origin in cardiology to its indication in the preventive treatment of migraine. Results: Propranolol was described in 1962 for the treatment of cardiovascular diseases. In the same decade, it was prescribed for the preventive treatment of migraine and, recently, included in the consensus of the Brazilian Headache Society. Conclusion: Although propranolol was initially synthesized for the treatment of heart disease, it has proved to be an effective drug in preventing migraine attacks

Introdução: O propranolol foi o primeiro bloqueador beta-adrenérgico não seletivo a ser desenvolvido. Inicialmente era utilizado no tratamento de doenças cardiovasculares, mas desde a década de 60 tem sido utilizado na prevenção de enxaquecas. Objetivo: O objetivo deste estudo foi conhecer a história do propranolol e seu uso como profilático para enxaqueca. Métodos: Este estudo foi uma revisão integrativa da literatura utilizando artigos com dados históricos sobre o propranolol, desde sua origem na cardiologia até sua indicação no tratamento preventivo da enxaqueca. Resultados: O propranolol foi descrito em 1962 para o tratamento de doenças cardiovasculares. Na mesma década, foi prescrito para o tratamento preventivo da enxaqueca e, recentemente, incluído no consenso da Sociedade Brasileira de Cefaleia. Conclusão: Embora o propranolol tenha sido inicialmente sintetizado para o tratamento de doenças cardíacas, provou ser um medicamento eficaz na prevenção de crises de enxaqueca

"Migrânea" or "enxaqueca": A historical and semantic review / "Migrânea" ou "enxaqueca": uma revisão histórica e semântica

Introduction: Headache is as old as the emergence of man on earth. A classification for headaches has been suggested for many centuries. After the invention of writing, numerous words were created to designate different types of headache. Objective: The objective of this review was to discuss the historical and etymological aspects of the terms "migrânea" and "enxaqueca". Methods: This study was an integrative review using articles with historical data on the etymology of the terms "migrânea" and "enxaqueca" and their evolution over the years. Results: The terms "migrânea" and "enxaqueca" have Greek and Arabic origins, respectively. Both describe a neurological syndrome characterized by headache and other associated symptoms. Usually, sufferers of this disease are more familiar with the term "enxaqueca" and confuse it with headache, while health professionals prefer the term "migrânea". Conclusions: After so many years that the term "migrânea" has been used, it would be a step backwards to use the term "enxaqueca" again, especially because "migrânea" has been adopted by young neurologists, including those from other specialties.

Introdução:A dor de cabeça é tão antiga quanto o surgimento do homem na terra. Uma classificação para dores de cabeça tem sido sugerida há muitos séculos. Após a invenção da escrita, inúmeras palavras foram criadas para designar diferentes tipos de dor de cabeça. Objetivo: O objetivo desta revisão foi discutir os aspectos históricos e etimológicos dos termos "migranânea" e "enxaqueca". Métodos: Este estudo foi uma revisão integrativa utilizando artigos com dados históricos sobre a etimologia dos termos "migranânea" e "enxaqueca" e sua evolução ao longo dos anos. Resultados: Os termos "migranânea" e "enxaqueca" têm origem grega e árabe, respectivamente. Ambos descrevem uma síndrome neurológica caracterizada por dor de cabeça e outros sintomas associados. Normalmente, quem sofre desta doença conhece mais o termo "enxaqueca" e confunde-o com dor de cabeça, enquanto os profissionais de saúde preferem o termo "migranânea". Conclusões: Depois de tantos anos de uso do termo "migranânea", seria um retrocesso usar novamente o termo "enxaqueca", até porque "migranânea" tem sido adotada por jovens neurologistas, inclusive de outras especialidades.

A double- blind, randomized, and placebo-controlled clinical trial with omega-3 polyunsaturated fatty acids (OPFA É·-3) for the prevention of migraine in chronic migraine patients using amitriptyline.

OBJECTIVE: To determine the prophylactic effect of OPFAϖ-3 in migraine. SUBJECTS AND METHODS: This was a prospective, experimental, controlled, double-blind, and with comparison groups study. Sixty patients diagnosed with chronic migraine, according to the criteria of the International Classification of Headache Disorders, Third Edition (beta version) (ICHD-3ß), were prophylactically treated with amitriptyline. They were divided into two equal groups: in group 1, prophylaxis was associated with OPFAϖ-3 and in group 2 with placebo. After 60 days, both groups were assessed by a second researcher. RESULTS: Of the 60 patients with chronic migraine, only 51 patients (15 men and 36 women) completed the treatment. The group that received OPFAϖ-3 consisted of 27 (52.9%) patients (six men and 21 women), while the control group was equal to 24 (47.1%) patients (nine men and 15 women). These differences were not significant (χ2 = 1.428; P = 0.375). In 66.7% (18/27) of the patients who used OPFAϖ-3, there was a reduction of more than 80.0% per month in the number of days of headache, while in the control group, the same improvement occurred in 33.3% (8/24) of patients. This difference was significant (χ2 = 5.649; P = 0.036). CONCLUSIONS: Polyunsaturated omega 3 fatty acids (OPFAϖ-3) are useful for prophylaxis of migraine attacks.