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Abstract(s)
A enxaqueca é o distúrbio neurológico mais prevalente na sociedade atual. Esta é
a terceira doença mais comum, e a oitava patologia mais debilitante a nível global,
afetando cerca de 324,1 milhões de pessoas, o que corresponde a 18,1% da população
mundial.(1) Em Portugal, a sua prevalência é ainda superior, afetando 19,3% dos
habitantes do nosso país.(2) Esta patologia, para além de ser bastante prevalente, está
associada a um aumento da morbilidade, à perda de produtividade dos doentes e a
elevados custos médicos, o que gera um enorme impacto a nível social e económico.
Após o diagnóstico de enxaqueca, a primeira abordagem terapêutica dos
pacientes é através do tratamento farmacológico. Apesar de o mesmo demonstrar
resultados positivos, este tratamento apresenta variados efeitos secundários e a sua
eficácia é normalmente reduzida.(3) Deste modo, foi proposto o conceito de cirurgia da
enxaqueca. Esta solução foi pensada para o tratamento definitivo da enxaqueca que não
é controlada por medicação, e consiste na realização de uma descompressão nervosa dos
pontos que se pensa estarem na origem deste tipo de cefaleia.(3) Esta é uma opção de
tratamento que não só foi considerada válida e praticável, como também tem
demostrado ser uma intervenção custo-efetiva que permite reduzir os custos diretos e
indiretos para os pacientes, bem como contribuir para a diminuição da morbilidade
relacionada com o quadro.(4)
Apesar dos benefícios, da segurança e da elevada taxa de sucesso demonstrada
em vários estudos para utilização deste procedimento, esta ainda não é uma abordagem
terapêutica largamente difundida e considerada como opção na maioria dos hospitais.(5)
Como tal, este trabalho tem como objetivo rever as atuais hipóteses de tratamento da
enxaqueca, sobretudo a intervenção cirúrgica.
Assim, pretende-se clarificar e comprovar as vantagens desta abordagem, para
que esta possa ser considerada nas orientações de tratamento para a enxaqueca em
doentes que não têm mais opções terapêuticas ou para aqueles que necessitam de uma
intervenção mais permanente para eliminar ou controlar os seus sintomas.
Para a realização desta monografia foi realizada uma pesquisa bibliográfica em
plataformas online de pesquisa e análise de literatura médica, tais como a PubMed,
Scopus e Web of Science, com a subsequente análise dos artigos publicados até à
atualidade. Através do estudo realizado, foi possível verificar que a cirurgia da enxaqueca
demonstrou ser um procedimento eficaz por vários grupos de trabalho e, como tal, um
método válido para o tratamento da enxaqueca em pacientes devidamente selecionados.
Migraine headache is the most prevalent neurological disorder today. It is the third most common disease and the eighth most debilitating condition globally, affecting about 324.1 million people, which corresponds to 18.1% of the world's population.(1) In Portugal, its prevalence is even higher, affecting 19.3% of the inhabitants of our country.(2) This condition, in addition to being highly prevalent, is associated with increased morbidity, loss of productivity for patients, and high medical costs, generating a significant impact on social and economic sectors. After the diagnosis of migraine, the initial therapeutic approach for patients is through pharmacological treatment. Despite showing positive results, this treatment has various side effects, and its efficiency is usually limited.(3) Therefore, the concept of migraine surgery has been proposed. This solution was designed for the definitive treatment of migraine headaches that are not controlled by medication, and involves nerve decompression at the points thought to be the origin of this type of headache.(3) This treatment option has not only been considered valid and feasible but has also proven to be a cost-effective intervention, reducing direct and indirect costs for patients and contributing to the reduction of morbidity associated with the condition.(4) Despite the benefits, safety, and high success rate demonstrated in various studies for the use of this procedure, it is not yet a widely disseminated therapeutic approach and is not considered an option in most hospitals.(5) Therefore, this work aims to review the current treatment options for migraine headache, spetially surgical intervention. Thus, the goal is to clarify and demonstrate the advantages of this approach so that it can be considered in treatment guidelines for migraine headache in patients who have no other therapeutic options or those who need a more permanent intervention to eliminate or control their symptoms. To conduct this monograph, a bibliographic search was conducted on online platforms for researching and analyzing medical literature, such as PubMed, Scopus, and Web of Science, with subsequent analysis of the articles published up to the present. Through the study, it was possible to verify that migraine surgery has proven to be an effective approach by various working groups and, as such, a valid method for treating migraine headache in appropriately selected patients.
Migraine headache is the most prevalent neurological disorder today. It is the third most common disease and the eighth most debilitating condition globally, affecting about 324.1 million people, which corresponds to 18.1% of the world's population.(1) In Portugal, its prevalence is even higher, affecting 19.3% of the inhabitants of our country.(2) This condition, in addition to being highly prevalent, is associated with increased morbidity, loss of productivity for patients, and high medical costs, generating a significant impact on social and economic sectors. After the diagnosis of migraine, the initial therapeutic approach for patients is through pharmacological treatment. Despite showing positive results, this treatment has various side effects, and its efficiency is usually limited.(3) Therefore, the concept of migraine surgery has been proposed. This solution was designed for the definitive treatment of migraine headaches that are not controlled by medication, and involves nerve decompression at the points thought to be the origin of this type of headache.(3) This treatment option has not only been considered valid and feasible but has also proven to be a cost-effective intervention, reducing direct and indirect costs for patients and contributing to the reduction of morbidity associated with the condition.(4) Despite the benefits, safety, and high success rate demonstrated in various studies for the use of this procedure, it is not yet a widely disseminated therapeutic approach and is not considered an option in most hospitals.(5) Therefore, this work aims to review the current treatment options for migraine headache, spetially surgical intervention. Thus, the goal is to clarify and demonstrate the advantages of this approach so that it can be considered in treatment guidelines for migraine headache in patients who have no other therapeutic options or those who need a more permanent intervention to eliminate or control their symptoms. To conduct this monograph, a bibliographic search was conducted on online platforms for researching and analyzing medical literature, such as PubMed, Scopus, and Web of Science, with subsequent analysis of the articles published up to the present. Through the study, it was possible to verify that migraine surgery has proven to be an effective approach by various working groups and, as such, a valid method for treating migraine headache in appropriately selected patients.
Description
Keywords
Cirurgia da Enxaqueca Descompressão Nervosa Enxaqueca Pontos Desencadeantes da Enxaqueca Tratamento da Enxaqueca