Prevalence of migraine in Latin America.

OBJECTIVE: To determine the 1-year point prevalence of migraine among residents > or =15 years old in 12 Latin American urban communities, and record medical consultation preferences of the identified migraineurs. BACKGROUND: Prevalence of migraine with or without aura in Latin American urban communities has not been established by large-scale population studies. METHODS: A validated face-to-face interview questionnaire based on International Headache Society criteria was completed for all headache sufferers within selected households, in a cross-sectional study. The randomly selected populations were representative of urban communities from the six participating Latin American countries. The questionnaire used was identical in each of the six participating countries. RESULTS: Of the 8618 people available for screening, 62% reported headache and 2637 completed interview questionnaires. Age-adjusted 1-year prevalence of migraine with or without aura for each country was (female/male, %): Argentina 6.1/3.8, Brazil 17.4/7.8, Colombia 13.8/4.8, Ecuador 13.5/2.9, Mexico 12.1/3.9, and Venezuela 12.2/4.7. Migraine prevalence was highest in women aged 30 to 50 years. In the year prior to the study, 42% of individuals interviewed and identified with migraine reported consulting a health professional about their headaches, most frequently (14%) a general practitioner. No previous diagnosis of migraine was reported by 65% of individuals with headache. CONCLUSIONS: 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.

Clinical characteristics and patterns of medication use of migraneurs in Latin America from 12 cities in 6 countries.

OBJECTIVE: The objective of this study was to document the clinical characteristics of migraine and patterns of medication use in residents > or =15 years old in 12 Latin American urban communities. BACKGROUND: Few large-scale population studies have established the symptoms and disability associated with migraine with or without aura in Latin American urban communities or the pattern of medication use in these regions. METHODS: In this study, subjects in 12 urban communities, from 6 Latin American countries, were surveyed with a validated face-to-face interview questionnaire based on International Headache Society criteria for migraine. The questionnaire was completed during face-to-face interviews with headache sufferers within selected households and included questions about migraine symptoms, migraine-related disability, and the use of health-care resources and medications to treat migraines. RESULTS: Of the 8618 people available for screening, 62% suffered from headaches. Of individuals with migraine, 42% reported consulting a health-care professional about their headaches. Of the migraineurs, 94.2% reported moderate to severe pain. Associated symptoms of nausea or vomiting, photophobia, phonophobia, and osmophobia were common during migraine attacks in 30.3, 76.4, 85.1, and 47.7% of subjects, respectively. The majority of subjects suffered between one and eight migraines each month. Although no previous diagnosis of migraine was reported by 65% of headache sufferers, migraineurs lost an average of 8 days in the preceding 3 months in any of the following areas: school, work, household chores, and/or social, family, or leisure activities. The agents used most widely to treat migraine were paracetamol and salicylates, while nonsteroidal anti-inflammatory drugs, dypirone, and ergotamines were also commonly used. Medication use varied widely among countries, but was predominantly nonprescription. CONCLUSIONS: 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.

Utilidad de la determinación post-ictal de prolactina sérica en la diferenciación entre crisis epilépticas y pseudocrisis / Usefulness of the ictal determination of seric prolactin in the differentiation between seizures and pseudoseizures

La clínica es uno de los principales soportes para el adecuado diagnóstico de las crisis epilépticas. Diferenciar una crisis tónico-clónica generalizada de un evento noepiléptico con componentes motores o una crisis parcial compleja de un evento epiléptico sin componente motor, puede desafiar incluso al clínico experimentado. Los electroencefalogramas, los registros simultáneos de video y EEG, las telemetrías, las pruebas de laboratorio facilitan el diagnóstico adecuado. Se ha demostrado en estudios previos que la prolactina se eleva durante estos eventos clínicos

Clasificación del TOAST en la práctica clínica de un hospital universitario / TOAST classification in the clinical practice in a universitary hospital

La clasificación de la enfermedad cerebrovascular inquémica por subtipos conlleva el doble interés de permitir un mejor y más rápido tratamiento para el paciente y una más fácil y adecuada caracterización de los factores de riesgo, lo que facilita la prevención secundaria. El objetivo del estudio fue evaluar la factibilidad de clasificar la enfermedad cerebrovascular isquémica según los parámetros utilizados por el TOAST, en los pacientes atendidos en un hospital universitario de la ciudad de Bogotá. La aplicación de los criterios dwe TOAST generó una alta proporción de ECV de etiología no determinada. La falta de estudios de los vasos intracerebrales ocasiona una sobreestimación de este grupo y una subestimación de pacientes con múltiples factores de riesgo y de gran vaso. Esta limitación obliga a replantear su uso en nuestro medio

Utilidad de la gammagrafía cerebral y del electroencefalograma para descubrir lesiones hemisféricas focales / Utility of cerebral gammagraphy and electroencephalogram for uncovering focal hemispheric lesions

Se estudió un grupo heterogéneo de 70 pacientes por sospecha clínica de lesión hemisférica focal (LHF) con gammagrafía cerebral (GC), electroencefalograma (EEG) y escanografía cerebral (EC). Se utilizó la EC como el examen de mayor sensibilidad y especificidad. La demostración o no de una imagen de LHF en la EC determinaba respectivamente la inclusión de cada paciente en el grupo de casos o de controles. Con la tabla de 4 casillas se analizaron 44 casos y 26 controles. Se construyó una curva característica operante relativa para la GC y el EEG. La GC fue siempre superior al EEG. Para una tasa de falsos positivos de 10% la sensibilidad de la GC fue 55%, mientras que para el EEG fue 45%. La probabilidad que un paciente tenga un LHF cuando tanto la GC y el EEG son negativos es 1%. Se sugiere que el uso combinado de la GC y el EEG es una estrategia diagnóstica eficaz para descubrir LHF