Amitriptilina e exercício aeróbico ou amitriptilina isolada no tratamento da migrânea crônica: um estudo randomizado e comparativo

To compare the preventive treatment benefits of amitriptyline and aerobic exercise or amitriptyline alone in patients with chronic migraine.Method Sixty patients, both genders, aged between 18 and 50 years, with a diagnosis of chronic migraine, were randomized in groups called amitriptyline and aerobic exercise or amitriptyline alone. The following parameters were evaluated: headache frequency, intensity and duration of headache, days of the analgesic medication use, body mass index (BMI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores. Results In the evaluated parameters, was observed decrease in headache frequency (p=0.001), moderate intensity (p=0.048), in headache duration (p=0.001), the body mass index (p=0.001), Beck Depression Inventory (p=0.001) and Beck Anxiety Inventory scores (p=0.001), when groups were compared in the end of third month. Conclusion In this study, the amitriptyline was an effective treatment for chronic migraine, but its efficacy was increased when combined with aerobic exercise.Comparar os benefícios do tratamento preventivo em pacientes com migrânea crônica utilizando a amitriptilina associada ao exercício aeróbico ou amitriptilina isolada.Método Sessenta pacientes de ambos os sexos com idade entre 18 e 50 anos e com diagnóstico de migrânea crônica foram randomizados para receber amitriptilina e orientados a: praticar exercícios aeróbicos ou somente a amitriptilina isolada. Os seguintes parâmetros foram avaliados: frequência, intensidade e duração da cefaleia, dias de uso de medicação analgésica, índice de massa corporal (IMC), e pontuação nas escalas de Beck Depression Inventory (BDI) e Beck Anxiety Inventory (BAI). Resultados Nos parâmetros avaliados, houve redução na frequência da cefaleia (p=0,001), intensidade moderada (p=0,048), na duração (p=0,001), no índice de massa corporal (p=0,001), e pontuação nas escalas Beck Depression Inventory (p=0,001) e Beck Anxiety Inventory (p=0,001), quando os grupos foram comparados ao final do terceiro mês. Conclusão A amitriptilina foi um tratamento eficaz para a migrânea crônica, mas sua eficácia foi maior quando combinada com exercício aeróbio.Universidade Federal de São Paulo (UNIFESP) Departamento de Neurologia e NeurocirurgiaUNIFESP, Depto. de Neurologia e NeurocirurgiaSciEL

Migrânea e cognição em crianças: um estudo controlado

OBJECTIVE: Evaluate the cognitive functions of children with migraine and compare them to A control group. METHOD: 30 migraineur children and 30 control group children without migraine, age ranging from 8 to 12 years old, were subjected to a cognitive functions assessment with Wechsler Intelligence Scale for Children (WISCIII). RESULTS: Although both groups had a normal cognitive performance, children with migraine had significantly worse scores compared to the control group in the subtests of Information, Arithmetic, Vocabulary, Object Assembly and in the Indexes of Perceptual Organization, Resistance to Distraction and Processing Speed. CONCLUSION: Children with migraine had impairment in some cognitive functions such as attention, memory, information speed, and perceptual organization compared to the control group.OBJETIVO: Avaliar as funções cognitivas de crianças com e sem migrânea, utilizando a Escala de Inteligência Wechsler para Crianças (WISC-III). MÉTODO: A amostra foi composta por 30 crianças com diagnóstico de migrânea na idade entre 8 a 12 anos e grupo controle de 30 crianças sem migrânea na mesma faixa etária. Todas foram avaliadas pela Escala de WISC-III. RESULTADOS: Embora ambos os grupos tenham demonstrado um quociente de inteligência dentro da média, as crianças com migrânea, quando comparados aos controles, tiveram desempenho inferior nos subtestes de Informação, Aritmética, Vocabulário, Armar Objetos e nos Índices de Compreensão verbal, Organização Perceptual, Resistência à Distração e Velocidade de Processamento. CONCLUSÃO: Quando comparadas aos controles, crianças com migrânea apresentaram desempenhos inferiores em vários domínios cognitivos como atenção, velocidade de processamento, memória e organização perceptual.Federal University of São Paulo Department of Neurology and Neurosurgery Division of Investigation and Treatment of HeadachesUNIFESP, Department of Neurology and Neurosurgery Division of Investigation and Treatment of HeadachesSciEL

Vestibular migraine: diagnosis challenges and need for targeted treatment

ABSTRACT Approximately 1% of the general population suffers from vestibular migraine. Despite the recently published diagnostic criteria, it is still underdiagnosed condition. The exact neural mechanisms of vestibular migraine are still unclear, but the variability of symptoms and clinical findings both during and between attacks suggests an important interaction between trigeminal and vestibular systems. Vestibular migraine often begins several years after typical migraine and has a variable clinical presentation. In vestibular migraine patients, the neurological and neurotological examination is mostly normal and the diagnosis will be based in the patient clinical history. Treatment trials that specialize on vestibular migraine are scarce and therapeutic recommendations are based on migraine guidelines. Controlled studies on the efficacy of pharmacologic interventions in the treatment of vestibular migraine should be performed