Introdução: A cefaleia é um sintoma comum durante o ciclo menstrual. A Sociedade Internacional de Cefaleia considera o diagnóstico “razoável” se 90% das crises estiverem compreendidas entre dois dias antes até três dias após o início do fluxo. O desencadeante primário da migrânea associado à menstruação parece ser as alterações nos níveis de estrogênio. O presente estudo busca associar a cefaleia ao ciclo menstrual, à Síndrome Pré-Menstrual (SPM), bem como relacionar suas causas e fatores agravantes.Objetivo: Verificar se, dentre estudantes de medicina com SPM, há maior prevalência de cefaleia e enxaqueca do que nas mulheres sem a síndrome; bem como avaliar se mulheres estudantes portadoras de cefaleia têm maior prevalência de síndrome pré-menstrual do que nas mulheres sem cefaleia.Método: Estudo de Coorte transversal realizado em 189 mulheres através de questionário semiestruturado. Aprovado pelo Comitê de Ética: CAAE - 84943718.0.0000.5430Resultados: Amostra foi composta de 189 participantes jovens, solteiras, estudantes de nível superior, usuárias de contraceptivos, com peso normal, e idades de início da SPM e Cefaleia semelhantes (cerca de 15 anos). Observou-se 41% das mulheres com migrânea menstrual (definição ampla). Foi observada associação entre cefaleia e SPM, o que é chamado de comorbidade (perto de 80% apresenta cefaleia e 81,5% apresenta enxaqueca) pelo teste de Fisher (p<0,01). Estimou-se que o risco de SPM é 2,54 vezes maior na população com cefaleia (1,417 a 4,445). Pelo teste de Fisher, foi observada associação entre SPM e a cefaleia menstrual em definição ampla (p>0001), com maior ocorrência de cefaleia menstrual na população com SPM. O risco de cefaleia menstrual “lato senso” é 70% maior na população com SPM (39,2% a 116,3%). Não houve correlação entre o tempo de SPM e a somatória de Headache Impact Test (HIT) (p=0,0866). Observou-se associação entre HIT e Diagnostic and Statistical Manual of Mental Disorders (DSM) V, de maneira que o maior número de sintomas de SPM são observados entre as que têm HIT igual ou maior que 50 (p<0,05).Conclusão: A associação entre SPM e migrânea é estatisticamente significativa e elevada. Estes distúrbios são comórbidos na população estudada. Migrânea relacionada à menstruação não é fator de risco para SPM e nem vice-versa.

Abstract The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.

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.

ABSTRACT 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.

Chronic migraine is a condition with significant prevalence all around the world and high socioeconomic impact, and its handling has been challenging neurologists. Developments for understanding its mechanisms and associated conditions, as well as that of new therapies, have been quick and important, a fact which has motivated the Latin American and Brazilian Headache Societies to prepare the present consensus. The treatment of chronic migraine should always be preceded by a careful diagnosis review; the detection of possible worsening factors and associated conditions; the stratification of seriousness/impossibility to treat; and monitoring establishment, with a pain diary. The present consensus deals with pharmacological and nonpharmacological forms of treatment to be used in chronic migraine.