Medicamentos Utilizados na Enxaqueca: Rotina em Unidades Básicas de Saúde e em Hospital / Drugs Used To Treat Migraine: The Routine Of Basic Healthcare Units And Hospitals

A cefaleia é um dos sintomas mais comuns naprática clínica e é responsável por um percentualconsiderável do atendimento em Unidades Básicas de Saúde(UBS) e em Hospitais. A enxaqueca (cefaleia migrânea), umsubtipo de cefaleia primária, é um dos diagnósticos maiscomuns no que se refere a cefaleias em geral. Por essemotivo, torna-se importante um estudo sobre os manejosclínicos, de caráter farmacológico, realizados no cuidardessa patologia. Objetivo: O objetivo do trabalho é fazeruma revisão bibliográfica de artigos que tratam da enxaqueca,e o tratamento farmacológico mais comum em UBS e Hospitais.Materiais e métodos: Para esta revisão foram utilizadosartigos indexados, publicados entre o período de 2002 a2012, nas bases de dados online Scielo e Pubmed, usandoos descritores: “cefaléia migrânea”, “fármacos e enxaqueca”,“enxaqueca e Unidades Básicas de Saúde” e “enxaqueca eemergências hospitalares”. Resultados: Devido à migrâneacausar um enorme desconforto ao paciente é necessáriouma abordagem rápida do problema para conferir a este,condições de manter as suas atividades diárias de formasatisfatória. Para isso, a terapêutica correta se destinaráaos episódios de crise – uso de medicamento para minimizaro sofrimento do paciente - e a profilaxia – uso demedicamentos a fim de reduzir o número de crises e aintensidade das mesmas. Conclusão: As UBS utilizam-se,para crises leves a moderadas, os analgésicos e antiinflamatórios;para as crises moderadas a intensa, osanalgésicos mais potentes e os triptanos. Enquanto que, nosHospitais, os corticoesteroides são as drogas de escolha,embora as aplicações de Diidroergotamina Endovenosa oude Clorpromazina também são alternativas...

Headache is one of the most common symptomsin clinical practice, which accounts for a considerablepercentage of appointments in Basic Healthcare Units (BHUs)and Hospitals. Migraine (migraine headache), a subtype ofprimary headache, is one of the most common diagnosesregarding headaches in general. Therefore, it becomesimportant to study the clinical pharmacological managementof this condition. Objective: This study aimed to review theexisting literature about migraine and the pharmacologicaltreatment performed in BHUs and hospitals. Material andMethods: Bibliographical searches were carried out in thedatabases Scielo and Pubmed of articles published between2002 and 2012, using the following descriptors: “migraineheadache”, “drugs and migraine”, “migraine and Basic HealthUnits”, “migraine and hospital emergencies”. Results: Asmigraine causes a strong discomfort to the patient, there is aneed for a quick approach to solve the problem andsatisfactorily maintain their daily activities. Therefore, anappropriate therapy should target episodes of crisis – use ofmedication to minimize patient suffering – and prophylaxis –use of medication to reduce the number and intensity ofseizures. Conclusions: BHUs prescribe analgesics and antiinflammatorydrugs in case of mild to moderate episodes,and potent analgesics and triptans in case of moderate tosevere episodes. Corticosteroids are the drugs of choice inthe hospital setting, although intravenous dihydroergotamineor chlorpromazine are also considered...

Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) / 소아과

PURPOSE: To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. METHODS: The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. RESULTS: Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was 6.3+/-3.6 yr, 8.5+/-2.7 yr, and 8.5+/-2.9 yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was 8.0+/-3.4 yr, 10.5+/-2.6 yr, and 10.1+/-3.2 yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). CONCLUSION: The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) / 소아과

PURPOSE: To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. METHODS: The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. RESULTS: Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was 6.3+/-3.6 yr, 8.5+/-2.7 yr, and 8.5+/-2.9 yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was 8.0+/-3.4 yr, 10.5+/-2.6 yr, and 10.1+/-3.2 yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). CONCLUSION: The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

Advance in Surgical Therapy for Migraine Headaches(review) / 中国康复理论与实践

@#Migraine headache causes significant burdens for both the individual and society.The pathogenesis of migraine is incompletely understood until now.The clinical therapies mainly include medical treatment,surgical treatment,behavior therapy,acupuncture and so on.However,drug treatment could only relieve symptom temporary and bring many side effects for long term use including nausea,vomiting.Surgical therapy maybe becomes an efficient method for migraine headache.The authors have reviewed the pathogenesis of migraine,anatomical basis for surgical therapy and clinical application in this article.

Advance in Surgical Therapy for Migraine Headaches(review) / 中国康复理论与实践

@#Migraine headache causes significant burdens for both the individual and society.The pathogenesis of migraine is incompletely understood until now.The clinical therapies mainly include medical treatment,surgical treatment,behavior therapy,acupuncture and so on.However,drug treatment could only relieve symptom temporary and bring many side effects for long term use including nausea,vomiting.Surgical therapy maybe becomes an efficient method for migraine headache.The authors have reviewed the pathogenesis of migraine,anatomical basis for surgical therapy and clinical application in this article.