In agreement with previous epidemiologic reports, migraine is also a common disorder in Latin American urban communities and predominantly affects women aged 30 to 50 years. Consultation preferences are also similar to those of previous reports.

The purpose of this study was to investigate the prevalence of migraine in medical students, as well as its clinical aspects and impact. All 595 medical students of Santa Casa School of Medicine of São Paulo, Brazil were asked if they had experienced any kind of headache in the past year. Those who responded positively were further investigated by an appropriate questionnaire. Diagnosis of migraine was based on the International Headache Society criteria of 1988. Forty percent of students suffered from some kind of headache; 40.2% of these headaches were migraine. The prevalence of migraine was 54.4% in women and 28.3% in men. Migraine headaches were unilateral in 24.2%, had a gradual onset in 69%, and were of a throbbing type in 88.3%. Migraine was considered incapacitating by 53.9% of students. Migraine with aura caused more disability than migraine without aura. Women experienced more intense migraine than men, and migraine with aura was especially more severe than migraine without aura. Photophobia, phonophobia, and nausea were more commonly encountered in migraine with aura. Despite the high prevalence, the high rate of disability, and the need for analgesic medication, only 7.1% of students with migraine had sought medical treatment.

Migraine is a common disorder in Latin American urban communities imposing significant burden on individuals, families, and communities. The magnitude of the impact and the range of activities affected by migraine are similar to those of previous reports in other regions. The preponderance of nonprescription medications and the scarcity of migraine-specific triptans from the study findings are especially striking.

In this article, a group of experts in headache management of the Brazilian Headache Society developed through a consensus strategic measurements to treat a migraine attack in both the child and the adult. Particular emphasis was laid on the treatment of migraine in women, including at pregnancy, lactation and perimenstrual period.

-The so-called short lasting primary headaches include heterogenic entities that can be divided between those without pronounced autonomic activation and those where this activation is evident, which includes the cluster-tic syndrome. We report five new cases with age closer to the trigeminal neuralgia's one, and concomitance of cluster headache and trigeminal neuralgia, which is less frequent in the literature. We also discuss briefly the pathophysiology of these clinical entities, suggesting that the trigeminus nerve is a common pathway of pain manifestation.KEY WORDS: cluster headache, trigeminal neuralgia, overlapping syndromes.Síndrome da cefaléia em salvas -neuralgia do trigêmio: relato de cinco novos casos RESUMO -As assim chamadas cefaléias primárias de curta duração incluem entidades heterogêneas podendo ser divididas entre aquelas sem importante ativação autonômica e aquelas onde esta ativação é evidente, nestas se inclui a síndrome cefaléia em salvas -neuralgia do trigêmeo (cluster-tic). Apresentamos cinco novos casos com faixa etária mais próxima da neuralgia do trigêmeo e com concomitância entre a cefaléia em salvas e a neuralgia do trigêmeo o que é muito menos frequente na literatura. Discute-se também brevemente a fisiopatologia desta entidade clínica sugerindo que o nervo trigêmeo é a via comum da manifestação dolorosa. PALAVRAS-CHAVE: cefaléia em salvas, neuralgia trigeminal, síndromes de superposição.The so-called short lasting primary headache syndromes include a heterogenic group of entities that can arise with remarkable autonomic activation, as in cluster headache, paroxystic chronic and episodic hemicrania, and in SUNCT (short lasting unilateral headache with conjuntival injection and tearing), oposed to those the autonomic features are virtually absent, as in continuous hemicrania and hypnic headache. This paper intends to discuss an uncommon affection, with just 39 reports in the literature, in which coexist trigeminal neuralgia and cluster headache, the so-called cluster-tic syndrome 1-3 , aiming to add five new occurrences with overlapping symptoms, which does not occur in the majority of the reported cases.The cluster-tic syndrome is characterized by the coexistence of two kinds of pain. One is strictly unilateral, usually periocular, with evident autonomic features, and daily attacks for weeks or months (cluster). The other is characterized by paroxysms similar to electric shocks (tics).In the reported cases the diagnosis of the overlapping conditions was made based on the criteria of the International Headache Society. The discussion will refer to the involvement of the V cranial nerve as a probable common pathway of two affections. All patients were treated with drug associations for neuralgia of the V pair and cluster headache.