Avaliação do manejo preventivo de pacientes com enxaqueca no ambulatório de neurologia do Centro de Especialidades do CESUPA no período de 2014-2018: um estudo retrospectivo

Abstract

Introduction: Migraine is one of the most prevalent causes of pain in Brazil and globally, being incapacitating when severe. They are primary headaches and are classified for their etiology in migraine with aura and without aura. Treatment is performed according to the specificity of migraine. Thus, it is imperative that there be a knowledge of the medical conduct on this subject, so that it cannot only diagnose and treat, but also adequately guide patients with migraine in outpatient services. Objective: To evaluate the preventive management of patients with migraine at the CEMEC-CESUPA Outpatient Neurology in the period 2014-2018. Methodology: Retrospective study of 961 patient charts from the CEMEC-CESUPA Neurology Outpatient Clinic. 52 charts followed the exclusion and inclusion criteria established for this research. The sample characterization information was compiled in databases prepared in Microsoft Office Excel® 2016 software; adopting a significance level α < 0.05. Results: There was a predominance of females (88.46%), with a prevalence of patients with migraine without aura (55.8%) compared to aura (44.2%). The most evident age at onset of migraine was between 19 and 30 years (39.1%). Among the patients analyzed, 88.5% reported severe pain and only 5.8% moderate pain, and there were no subjects who reported poor pain or absence of pain. Migraine attacks usually occur in 50% of cases 3 to 14 times a month, followed by 15 to 30 times monthly (44.7%); its average duration is 4 to 72 hours in 64.1% of patients. The prodrome with the highest prevalence in the research were the scotomas (78.9%). Its most frequent triggering factors were stress (60.5%), food (32.6%) and sleep (32.6%); among the foods, coffee and chocolate (35.7% and 28.6%, respectively) were the most prevalent. In the morbid antecedents, systemic arterial hypertension and psychiatric diseases were the most mentioned in this study (41.9% and 38.7%, respectively). Among the most frequently mentioned life habits during non-pharmacological treatment, the therapeutic activity prevailed (55%). Of the patients evaluated, 40% of evasion was observed after the first return visit. There was little filling of the headache diary (34%). The prevalence of the main drugs used in prophylactic therapy were tricyclic derivatives (77%), topiramato (23%), flunarizine (9.5%) and propranolol (11.5%). It was noted that 66.6% of the patients were using abusive analgesics before treatment. Conclusion: The main benefits of this study for the CEMEC-CESUPA outpatient clinic of Neurology are the contribution of the scientific analysis to the elaboration of adherence strategies for the patients treated in this clinic and the elaboration of a proposal for a headache diary.