Abstract
Background: Chronic migraine is a neurological disorder described as refractory to preventive treatments. Based on the PREEMPT study, the National Institute for Health and Clinical Excellence (NICE) and the FDA approved, in 2010, the use of Botulinum Toxin type A (BoNT/A) to treat refractory chronic migraine. Objectives: To review the effectiveness of the use of BoNT/A in the treatment of refractory migraine. Methods: Bibliographic review based on PubMed database, using the descriptors “migraine” and “botulinum toxin”. Clinical trials, meta-analyzes and randomized controlled tests, from the last five years, were defined as inclusion criteria. Results: Sanz et al., (2016) infiltrated BoNT/A in 69 patients - mean age 43 years old, 88.4% women, mean infiltration rate was 2,0. The reduction of headache days and pain intensity was 48.5% and 20.5%, respectively, both statistically significant (p <0.006). Ion et al., (2018) intervened 61 patients - mean age 50 years old, 87% women, mean infiltration of 3.5. 73% showed a reduction greater than 50% for the frequency of migraine episodes, 48% for headache days and 48% for drug use. Dodick et al., (2019) applied BoNT/A in 688 patients - 696 received placebo. The severity and frequency of pain showed a statistically significant reduction (p < 0.001) after the first week of treatment in relation to the control group. Conclusions: The use of BoNT/A to treat refractory chronic migraine proves to be effective, although there is need for studies with larger samples to ensure its effectiveness.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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