Consulting behaviour in migraine and tension-type headache sufferers: a population survey in Santiago, Chile.

Migraine and tension-type headaches are the most frequent types of headaches in Santiago. The purpose of this paper is to describe the patterns of health care utilization in migraine and compare them with tension-type headache sufferers in a community-based study of the prevalence of headache in Santiago, Chile. A two-step questionnaire was administered to an age- and gender-representative sample of 1540 eligible subjects who were aged 15 years or older. Of these, 1385 (89.9%) responded. Cases were defined according to the most frequent type of headache experienced in the last year. Migraine and tension-type headaches were diagnosed according to a questionnaire-based algorithm constructed using the IHS criteria. Consultation rates in migraneurs were significantly (P < 0.01) higher (63%) than in tension-type headache suffers (39%). Migraneurs were more likely to be female, younger and less educated, and had more severe attacks than those with tension-type headache. Female sex, younger age, fewer years of education in migraneurs and younger age and moderate or severe headache in tension-type headache sufferers were found to be independently associated with the likelihood of ever consulting, respectively. Migraneurs are more likely to consult than tension-type headache suffers in this population.

Evaluación sensitiva y sensorial postglosectomía parcial en procedimientos de cirugía ortognática

El propósito de este esudio fue evaluar sensorialmente y sensitivamente la glosectomía parcial (tecnica de Obwegeser modificada) como intervención complementaria a la cirugía ortognática.Material y Método. Fue estudiado un universo de 30 pacientes. El grupo experimental estuvo formado por 15 pacientes operados. El grupo control lo constituyen 15 pacientes sanos, no operados y de similares características etarias. Se evaluó el postoperatorio a través de un exámen que abarcó pruebas sensitivas y sensoriales. Además se aplicó un cuestionario a los pacientes operados sobre su percepción comparativa pre y postoperatoria de los aspectos estudiados experimentalmente. Los resultados fueron analizados estadísticamente a través de tests paramétricos (test "T" de Student no apareado) y no paramétricos (chi-cuadrado y Mann-Whitney), utilizando una p <0,05.Resultados. En la muestra estudiada, la percepción gustativa y térmica no se muestran alteradas. Puede presentarse una disminución post- quirúrgica leve de la sensibilidad dolorosa. Los pacientes después de operados quedan conformes con los resultados (AU)

Epidemiology of tension-type headache in Santiago, Chile: a prevalence study.

OBJECTIVE: To describe the importance of tension-type headache (TTH) in Santiago, Chile, by analyzing its prevalence, clinical features, and impact by age, gender, and socioeconomic status, using widely accepted international diagnostic criteria. METHODS: In 1993, a representative sample of 1540 adults (older than 14) of the province of Santiago were interviewed using a standard questionnaire. A total of 1385 (89.9% response rate) subjects responded to the survey. Initially, a designated member of each household responded to the questionnaire. Subsequently, each household member with headache was asked to respond to questions about the severity, frequency, location, duration, associated symptoms, and impact in work and social activities of their most frequent headaches. TTH diagnoses were determined in accordance with the International Headache Society criteria of 1988. RESULTS: Total prevalence was found to be 26.9% (95% CI: 24.6-29.3%); 35.2% in females (95% CI: 31.7-38.8%) and 18.1% in males (95% CI: 15.2-21.3%). The prevalence of episodic TTH was 24.3% (95% CI: 22.1-26.7%) and of chronic TTH 2.6% (95% CI: 1.8-3.6%). Overall, and by subtype, prevalence was significantly higher in females (ratio 1:9). There was no significant variation in prevalence by socioeconomic or age group except in chronic TTH, in which there was an increase with age. CONCLUSIONS: TTH is a prevalent condition in a sample of adults of Santiago, similar to that reported in previous studies using similar methodologies. Overall, TTH represents 72.3% of all recurrent headaches.

Epidemiology of migraine headache in Santiago, Chile: a prevalence study.

OBJECTIVE: To describe the importance of migraine in Santiago, Chile, by analyzing its prevalence, clinical features and impact by age, gender and socioeconomic status. METHODS: In 1993, a representative sample of 1,540 adults of the province of Santiago were interviewed using a standard questionnaire. A total of 1,385 (89.9%) subjects responded to the survey. Initially, a designated member of each household responded to the questionnaire. Subsequently, each household member with headaches was asked to respond to questions about severity, frequency, location, duration, associated symptoms and impact in work and social activities of their most frequent headaches. Migraine diagnoses were determined in accordance with the International Headache Society (IHS) criteria of 1988. RESULTS: Recurrent headaches in the past year were found in 516 (36.82%) respondents, 145 (28.1%) males and 371 (71.9%) females. Total prevalence of migraine was found to be 7.3% (95% CI 5.9-8.6); 11.9% (95% CI 9.6-14.2) in females and 2.0% (95% CI 0.9-3.0) in males. Overall, migraine constituted 19.6% (101/516) of all headaches reported in this sample. The prevalence did not vary significantly by age groups or socioeconomic status (SES). Migraine with aura had an overall prevalence of 3.5% (CI 0.8-7.1), and was significantly more frequent in females. In 60-70% of cases the attacks lasted 2-6 h and the frequency was 3.3 and 3.4 per month in females and males respectively. Both males and females reported significantly high percentages of attacks during work. CONCLUSIONS: Migraine prevalence in a sample of adults of Santiago is similar to that reported in previous studies using IHS criteria. Women of all socioeconomic levels are at an increased risk.

[Sympathetic denervation of an extremity as a presentation form of apical lung cancer]. / Denervación simpática de una extremidad como forma de presentación en cáncer del vértice pulmonar.

We report a 56 years old male patient presenting with a sympathetic denervation of the right upper limb due to an apical lung cancer. Vasomotor paralysis of the limb was objectively documented with a contact termography. The clinical presentation of this patient was unusual, considering that the alteration occurred without sensory or motor changes of the limb or autonomic disturbances of the face. The absence of clinical and neurophysiological involvement of large and small caliber fibres of the brachial plexus and the lack of autonomic dysfunction of the face was explained by a predominant tumoral infiltration of T2 and T4 ventral roots, which supply autonomic innervation to the upper limbs.

[Neuroacanthocytosis: report of 3 cases]. / Neuroacantocitosis: comunicación de 3 casos.

Neuroacanthocytosis is a syndrome characterized by extrapyramidal neurologic manifestations such as chorea, dystonia, parkinsonism or tics and acanthocytosis in the blood smear. It is often associated with self aggression (lips and tongue bites) and arreflectic amyotrophy of the extremities. Three adult patients with the characteristic neurologic manifestations of the syndrome, acanthocytosis in the blood smear and normal plasma lipoproteins are presented. Kell antigen was negative in all the patients. Two patients presented as a Gilles de la Tourette syndrome and one as a familiar Chorea. The diagnosis must be suspected in adult patients with extrapyramidal manifestations and in whom the blood smear shows the presence of acanthocytosis. This is the first report of neuroacathocytosis in Chile and the second in a group of patients of hispanic origin.