Recommendations for the treatment of migraine attacks - a Brazilian consensus

Bordini, Carlos Alberto; Roesler, Célia Aparecida de Paula; Carvalho, Diana Paula de Souza Rêgo Pinto; Macedo, Djacir Dantas Pereira de; Piovesan, Élcio Juliato; Melhado, Eliana Meire; Dach, Fabíola; Kowacs, Fernando; Júnior, Hilton Mariano da Silva; Souza, Jano Alves de; Maciel, Jayme Antunes; Carvalho, João de Freitas de José; Speciali, José Geraldo; Barea, Liselotte Menke; Queiroz, Luiz Paulo; Ciciarelli, Marcelo Cedrinho; Valênça, Marcelo Moraes; Lima, Márcia Maria Ferreira; Vincent, Maurice; Jurno, Mauro Eduardo; Monzillo, Paulo Hélio; Filho, Pedro Ferreira Moreira; Domingues, Renan Barros

doi:10.1590/0004-282x2015021

Cited by 17 publications

(20 citation statements)

References 24 publications

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“…In the present study, the prevalence of migraine after menopause was similar to that found by other authors 3 and nearly a quarter of the postmenopausal women in our series had migraine attacks. This result is in agreement with a recent expert consensus on the matter 15 . The majority of the cases of migraine in this series did not show severe disability.…”

Section: Discussionsupporting

confidence: 93%

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

Carturan

Scorcine

Fragoso

2016

Arq. Neuro-Psiquiatr.

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Objective To assess the prevalence of headache in post-menopausal women. Methods Women attending gynecology outpatient services in the coastal region of the state of Sao Paulo, Brazil were invited to participate in this study. Only those with non-surgical menopause and no hormone replacement therapy were included. Prevalence and characterization of headaches were assessed, as well as the burden of migraine, traits of anxiety and depression, and menopausal symptomatology. Results One hundred and three women were included in the study. Migraine affected 14.7% of them. Some previous type of headache was reported by 86.2% of the women, most of whom improved during menopause but still presented with headache attacks. There was a correlation between higher migraine disability and depressive traits. Conclusions Many women believe that their headaches, particularly migraine, will end after menopause. This is, unfortunately, not the case for many of them.

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Section: Discussionsupporting

confidence: 93%

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

Carturan

Scorcine

Fragoso

2016

Arq. Neuro-Psiquiatr.

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“…A more severe attack that is lasting longer than usual and refractoriness to oral and/or usual therapeutic options may represent the most common causes of seeking care in hospital environments. 15,16 Although there is not a reliable consensus with the real experts to fundament local approaches in Brazil, it is universally accepted that patients must have their migraine diagnosis emphasized as well as confirmed. Migraineurs may suffer secondary headaches despite having a previous diagnosis of a primary headache.…”

Section: Discussionmentioning

confidence: 99%

“…The patient must be assisted in a place that allows resting in a dark and quiet environment. 16 Regarding medications, many of the patients from this study received the most common treatment option in Brazilian ED, which is the pirazolonic derivative dipyrone (metamizol). Although dipyrone show effectiveness, good speed of action, and a favorable safety profile for the acute treatment of migraine with or without aura and associated symptoms of migraine, promoting up to 40% pain-free rates after 60 minutes, there are more effective injectable treatments.…”

Section: Discussionmentioning

confidence: 99%

Migraine Treatment in Emergency Departments of Brazil: A Retrospective Study of 2 Regions

Krymchantowski¹,

Jevoux²,

Silva‐Néto

et al. 2020

Headache

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Objective This study describes the approaches, medications used, and time of care for migraineurs, who have been in emergency departments (ED) from 2 different regions of Brazil. Methods Retrospective, cross‐sectional, observational, non‐randomized study of migraine patients seen at 2 headache centers in Brazil. Results Eighty‐four migraine patients (15 men and 69 women) were divided into 2 groups: chronic (19%, n = 16) and episodic migraineurs (81%, n = 68). In the ED, medications were used in the following order of frequency: dipyrone or metamizole (89.3%, 75/84), nonsteroidal anti‐inflammatory drugs (57.1%; 48/84) opioids (51.1%; 43/84), metoclopramide (29.8%; 25/84), dexamethasone (28.6%; 24/84), chlorpromazine (13.1%; 11/84), and subcutaneous sumatriptan (7.1%; 6/84). The average time in the care center was 8.2 hours, but only 23 patients (27.4%) left the hospital with greater than 50% relief in headache severity. Conclusions Dipyrone and nonsteroidal anti‐inflammatories were the most used drugs, but nearly half received opioids. More efficient drugs were poorly used. Considering the number of patients leaving the hospital with headache relief, a changing treatment paradigm should be carried out in Brazil.

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“…Aqueles pacientes que o odor inalado desencadeou crises de dor foram prontamente medicados no ambulatório com anti-inflamatório e triptana, conforme descrito nas Recommendations for the treatment of migraine attacks -a Brazilian consensus. 13…”

Section: Delineamento Do Estudounclassified

Prevalence of osmophobia in migrainous patients and analysis of triggering odors

Milagres¹,

Paula²,

Mendonça³

et al. 2018

Revista Médica De Minas Gerais

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Objetive: Evaluate the prevalence of osmophobia in migrainous patients and verify the worst interpreted odor family or one that would act as a trigger to crisis. Methods: Cohort cross-sectional clinical study with 141 patients, evaluating the prevalence of osmophobia in individuals diagnosed with migraine. It questioned the presence of osmophobia and the evaluation was made by means of inhalation of six odors presented randomly and with no suggestion towards identification. After smelling the perfumes, the patients attributed a score to the provoked bother, being "0" indifferent and "10" unbearable. In the end, the presence of pain crisis was questioned, in case of a positive response, what was the triggering odor. Results: The prevalence of osmophobia was 61.7%, with a mean age of 31.28 ± 12.57 years old, with 80.8% being women, and the osmophobia was more prevalent in those, 30.5% had a crisis after the odor presentation and 79.1% identified the triggering odor. For all odors, the individuals that reported pain crisis and osmophobia always attributed higher scores. Conclusion: Osmophobia was prevalent and the essences worked as pain triggers, however, it wasn't found an odor that stood out in the capacity of triggering migrainous crisis.

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Recommendations for the treatment of migraine attacks - a Brazilian consensus

Cited by 17 publications

References 24 publications

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

Migraine Treatment in Emergency Departments of Brazil: A Retrospective Study of 2 Regions

Prevalence of osmophobia in migrainous patients and analysis of triggering odors

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