Sinais clínicos da migrânea vestibular em adolescentes / Clinical signs of vestibular migraine in adolescents / Signos clínicos de la migraña vestibular em adolescentes

Introdução: A migrânea é um tipo de cefaleia primária incapacitante que, quando associada a crises de vertigem, configura-se migrânea vestibular. Objetivo: Verificar quais as principais manifestações clínicas da migrânea vestibular em adolescentes. Métodos: Trata-se de uma revisão integrativa da literatura, cujas buscas foram executadas nas bases de dados eletrônicas PubMed/Medline, Scientific Electronic Library Online (SciELO), e Portal da Biblioteca Virtual em Saúde (BVS), em junho de 2022. Foram incluídas publicações entre o ano 2012 e o mês de junho de 2022; estudos observacionais e ensaios clínicos envolvendo seres humanos, nos quais o objetivo fosse avaliar indivíduos com idades entre 12 e 19 anos com diagnóstico de migrânea vestibular e verificar suas principais manifestações clínicas nessa população. Resultados: Todos os estudos mencionaram um maior percentual de meninas nas amostras, porém a diferença entre os sexos para os diferentes diagnósticos não foi avaliada em todas as pesquisas. Conclusão: Verificou-se, com a presente revisão, que as manifestações clínicas da migrânea na adolescência são semelhantes às da população adulta. (AU)

Introduction: Migraine is a disabling type of primary headache that, when associated with vertigo attacks, constitutes vestibular migraine. Objective: To investigate the main clinical findings of vestibular migraine in adolescents. Methods: This is an integrative literature review, with searches conducted in the electronic databases PubMed/Medline, Scientific Electronic Library Online (SciELO), and the Virtual Health Library Portal (BVS) in June 2022. Publications from the year 2012 to June 2022 were included; observational studies and clinical trials involving human subjects, in which the objective was to assess individuals aged 12 to 19 years diagnosed with vestibular migraine and investigate their main clinical findings in this population. Results: All studies mentioned a higher percentage of girls in the samples; however, the difference between sexes for different diagnoses was not assessed in all studies. Conclusion: With this review, it was found that the clinical findings of migraine in adolescence are similar to those in the adult population. (AU)

Introducción: La migraña es em tipo de dolor de cabeza adolescente incapacitante que, cuando se dolesc em ataques de vértigo, constituye la migraña vestibular. Objetivo: Investigar las principales manifestaciones clínicas de la migraña vestibular em adolescentes. Métodos: Se trata de em revisión integradora de la literatura, em búsquedas realizadas em las bases de datos electrónicas PubMed/Medline, Scientific Electronic Library Online (SciELO) y el Portal de la Biblioteca Virtual em Salud (BVS) em junio de 2022. Se incluyeron publicaciones desde el año 2012 hasta junio de 2022; dolescê observacionales y ensayos clínicos que involucraran a sujetos humanos, en los cuales el objetivo fuera evaluar adolescentes de 12 a 19 años en diagnóstico de migraña vestibular e investigar sus principales manifestaciones clínicas em esta población. Resultados: Todos los adolescentes mencionaron en mayor porcentaje de niñas en las muestras; sin embargo, la diferencia entre los sexos para diferentes diagnósticos no fue evaluada en todos los adolescentes. Conclusión: En esta revisión, se descobrió que las manifestaciones clínicas de la migraña en la dolescência son similares a las de la población adulta. (AU)

Cefalea de tipo SUNCT secundaria a infección por el virus herpes zóster. A propósito de un caso / SUNCT-type headache secondary to herpes zoster virus infection. A case report

Introducción. La cefalea es uno de los motivos más frecuentes de consulta médica. La de tipo SUNCT forma parte de las cefaleas primarias de tipo trigeminoautonómico y debe considerarse en casos de dolor hemifacial de corta duración asociado a signos disautonómicos. Adicionalmente, dentro del enfoque de esta enfermedad se deben descartar causas secundarias que faciliten su aparición. Caso clínico. Se describe un caso de cefalea de novo de tipo SUNCT en el cual se documentó afectación de la primera rama del nervio trigémino por infección del virus herpes zóster tras seis días de aparición del dolor. Conclusión. Habitualmente, las cefaleas trigeminoautonómicas son primarias; sin embargo, existen múltiples entidades descritas asociadas a cefalea de tipo SUNCT de etiología secundaria. Dentro de éstas debe considerarse la infección por el virus herpes zóster en el inicio de episodios compatibles con cefalea de tipo SUNCT que no respondan al tratamiento médico.(AU)

Introduction. Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered in cases of short-lasting, hemifacial pain associated with autonomic dysfunction. Additionally, in the approach to this disease, secondary causes that facilitate its onset must be ruled out. Case report. We describe a case of a new-onset SUNCT-type headache in which involvement of the first branch of the trigeminal nerve due to herpes zoster virus infection was documented six days after the onset of pain. Conclusion. Trigeminal autonomic headaches are usually primary; yet, multiple conditions have been described that are associated with SUNCT-type headaches and have a secondary etiology. Among these, herpes zoster virus infection should be considered at the onset of episodes consistent with SUNCT-type headache unresponsive to medical treatment.(AU)

Headache in young patients: Clinical characteristics of a series of 651 cases. / Cefalea en jóvenes: características clínicas en una serie de 651 casos.

INTRODUCTION: Headache has a negative impact on health-related quality of life in young patients. We aim to analyse the characteristics of a series of young patients visiting a headache clinic and estimate the burden of different types of headaches listed by the International Classification of Headache Disorders (ICHD). METHODS: We prospectively recruited patients aged 14 to 25 years who were treated at our clinic during a period of 6.5 years. We recorded each patient's sex, complementary test results, and previous treatment. We subsequently compared the characteristics of our sample to those of patients older than 25. RESULTS: During the study period, we treated 651 patients aged 14 to 25 years; 95.6% had received symptomatic treatment, and 30.1% had received preventive treatment. A total of 755 headaches were recorded. Only 80 were secondary headaches, most of which were included in Group 8; 77.2% were included in Group 1, 3.1% in Group 2, 1.2% in Group 3, 5% in Group 4, 0.6% in Group 13, and 0.9% in Group 14. According to Headache Impact Test (HIT-6) scores, headache had at least a moderate impact on the quality of life of 449 patients. CONCLUSION: Most headaches in young patients can be classified according to ICHD criteria. Migraine was the most frequent diagnosis in our sample. Although headache was commonly associated with a negative impact on quality of life, most patients had received little preventive treatment before being referred to our clinic.

La hipnosis en el tratamiento de las cefaleas / Hypnosis in the treatment of headache disorders

las cefaleas constituyen una de las dolencias más frecuentes, afectando la calidad de vida de muchas personas. La hipnosis se ha mostrado como una poderosa intervención para este problema de salud y califica como un tratamiento bien establecido según los criterios de Chambless y Hollon. Objetivo: destacar la efectividad de la hipnosis en el tratamiento de las cefaleas, mostrando el apoyo empírico que posee esta intervención según los criterios de tratamientos de la American Psicologocal Association (APA). Métodos: se analizaron artículos originales, de revisión así como estudios de casos que hubieran sido publicados fundamentalmente en los últimos 5 años y abordaran la temática. La búsqueda se realizó en las bases de datos: Pubmed, SciELO, DynaMed y Ebsco Host, escogiéndose descriptores tanto en español como en inglés. Conclusiones: los estudios coinciden en que la hipnosis es un tratamiento relativamente breve, libre de efectos secundarios y reacciones adversas, y estable en la reducción de los gastos asociados a los ampliamente utilizados tratamientos médicos. Una parte importante de las investigaciones se refiere a adultos y fundamentalmente al tratamiento de cefaleas primarias. La hipnosis también podría ser útil para tratar algunas cefaleas secundarias, pero aún se hacen necesarios más estudios(AU)

Headaches constitute one of the most frequent ailments, affecting the quality of many people's life. Hypnosis has proven to be a powerful intervention for this problem of health and it qualifies as a well-established treatment according to the approaches of Chambless and Hollon. Objective: to highlight the effectiveness of hypnosis in the treatment of headaches, showing the empiric support that possesses this intervention according to the approaches of treatments of the American Psychological Association (APA). Methods: original and revision articles were analyzed as well as case reports that had been published fundamentally in the last 5 years and that approached the theme. The search was carried out in the databases: Pubmed, SciELO, DynaMed and Ebsco Host, being chosen describers in Spanish and English.Conclusion: studies coincide that hypnosis is a relatively brief treatment, free of side effects and adverse reactions, and stable in the reduction of the expenses associated to the broadly used medical treatments. An important part of the investigations are referred to adults and fundamentally to the treatment of primary headaches. Hypnosis could also be useful to treat some secondary headaches, but more studies are still needed(AU)

Migraña hemipléjica esporádica: a propósito de un caso clínico / Sporadic hemiplegic migraine: a clinical case

Las cefaleas constituyen una causa frecuente de consulta en pediatría, siendo la migraña el tipo más frecuente de cefalea primaria en la infancia. La migraña hemipléjica (MH) es una variante infrecuente de migraña con aura, reconociéndose dos subtipos: familiar (MHF) y esporádica (MHE). Se caracteriza por la presencia de crisis migrañosas con trastornos motores deficitarios transitorios, afasia o alteraciones sensitivas o sensoriales. Describimos el caso de una niña de 9 años, sana, sin antecedentes familiares de MH, con una historia de cefaleas migrañosas de 3 años de evolución, que cumple con los criterios establecidos por la International Headache Society de MHE. El examen neurológico fuera de los episodios y los exámenes complementarios fueron normales. Se realizó tratamiento profiláctico con topiramato con buena evolución.

Headache is a frequent cause of pediatric medical consultation, migraine is the most frecuent child primary headache. Hemiplegic migraine (HM) is a rare subtype of migraine with aura headache, it has two variants: familial (FHM) and sporadic (SHM). It presents with migraine attacks associated with some degree of transient hemiparesia, dysphasic speech or sensitive or sensorial symptoms. We describe a 9 years old girl, healthy, without familial history of HM, with 3 years evolution of migraine headaches that fulfill the International Headache Society`s criteria for SHM. The neurologic examination and laboratory tests were normal...

Otras cefaleas primarias / Other primary headaches

El capítulo de otras cefaleas primarias, abarca un grupo de cefaleas descritas como desórdenes clínicos heterogéneos. Aunque estas entidades no son frecuentemente encontradas en el escenario clínico es relevante conocer los aspectos epidemiológicos, fisiopatológicos, clínicos y de tratamiento concernientes. Una de las características de mayor relevancia en este grupo está dado por el pobre entendimiento de los mecanismos fisiopatológicos y por las recomendaciones terapéuticas basadas en reportes anecdóticos por lo tanto la Asociación internacional de dolor de cabeza estimula la investigación de estas entidades en pro de adquirir un mayor grado de comprensión de este tipo de cefaleas. Presentamos una revisión de los principales artículos relacionados con hemicrania continua, cefalea hípnica, cefalea primaria por tos, cefalea primaria relacionada con actividad sexual, cefalea primaria por ejercicio, cefalea primaria tipo punzada, cefalea primaria tipo trueno y nueva cefalea diaria persistente.

This chapter, other primary headaches, encompasses a group of headaches that are described as heterogeneous clinical disorders. Although these entities are not frequently seen in the setting of general consultation, it is relevant to know the most important aspects related to epidemiology, clinical manifestations, pathogenesis and treatment. One of the most relevant features of this group is that pathogenesis and suggested treatments are based in hypothetical descriptions and anecdotal reports therefore the International headache association aims to stimulate further investigations of these entities in order to get broader comprehension of this group. We review recent important papers pertaining to hemicrania continua, hypnic headache, primary cough headache, primary headache related to sexual activity, primary exertional headache, primary stabbing headache, primary thunderclap headache and new daily persistent headache.

Cefaleas primarias revisión de criterios diagnósticos y abordajes terapéuticos / Primary cephaleas: a revision of its diagnosis and therapeutic approach

Esta revisión aborda las cefaleas primarias, su diagnóstico y tratamiento. Para la IHS son: migraña, cefalea tensional, cluster y otros. Migraña: La segunda en prevalencia y la de mayor morbilidad, el aura diferencia la migraña con aura (Mca) de la sin aura (Msa). Epidemiología: prevalencia 10% con una relación 3: 1 mujer-hombre. Fisiopatología: es un trastorno nociceptivo central primario, con compromiso secundario vascular. Tratamiento: específico y no específico, tanto de las crisis como preventivo. Trastornos psiquiátricos y migraña: existe evidencia de correlación clínico patológica y farmacológica mayormente entre Mca y diversas patologías psiquiátricas. Migraña en el niño: se presenta con diferencias clínicas responde a otra farmacoterapia y es de gran importancia el enfoque familiar. Migraña y hormonas: el principal factor hormonal relacionado a la migraña es la caída hormonal. Migraña y epilepsia: comparte la hiperexcitabilidad cerebral y medicación. Migraña y enfermedad cerebrovascular: factores vasculares e isquémicos comunes. Medicina basada en la evidencia: supone un importante avance en la medición de la efectividad de los tratamientos. Cefalea tensional: la más frecuente de todas las cefaleas, subdiagnosticada. Diferencias entre episódica y crónica. Epidemiología: leve preponderancia femenina. Fisiopatología y factores influyentes: destaca el rol del sistema nociceptivo, el sedentarismo, el estrés y la tensión muscular. Tratamiento: farmacológico y no farmacológico. Cefalea en racimo: de menor prevalencia pero con clínica frondosa, muy invalidante pero con tratamiento efectivo. Otras cefaleas primarias: es importante desensibilizar de los factores desencadenantes. Conclusión: rescatamos conceptos sobre la tarea del médico de aliviar el sufrimiento del paciente, a través de un diagnóstico y un tratamiento adecuados.

This review focuses on primary headaches, its diagnosis and treatment. For the IHS specialists they are: migraine, tension-type headache (TTH), cluster and others. Migraine: the second in prevalence and the first in morbility, clinical features and differences between migraine with (Ma) and without aura (Mo). Epidemiology: 10% prevalence and 3: 1 women to men proportion. Patophysiology: primary central nociception disorder with secondary vascular involvement. Treatment: specific and non-specific, acute and preventive. Psychiatric disorders and migraine: there is evidence of clinical and pharmacologicallinks, mainly between Ma and several psychiatric disorders. Migraine in children’s: important clinical and therapeutic differences from adult, importance of family approach. Migraine and hormones: the importance of estrogens drops, as trigger factor, treatment. Migraine and epilepsy: both shares neuronal hyperexcitability pattern. Migraine and stroke: vascular and ischemic factors involved. Evidence-based medicine: improves treatment's results and studies outcome evaluation. TTH: first in prevalence, still highly sub diagnosed. Main clinical presentations: episodic and chronic. Epidemiology: slight female preponderance. Patophysiology and trigger factors: the role of limbic nociceptive system, sedentarism stress and muscular tension. Treatment: pharmacological and non-pharmacological. Cluster headache: low prevalence but high daily-living activities impact, effective treatment. Other primary headaches: variability of trigger factors and role of desensitization process. Conclusion: we remark the complexity of headache and the of physicians' role: to relief patients suffering, throughout a precise diagnosis and treatment.