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Headache Medicine
ISSN 2178-7468
e
-ISSN 2763-6178
v.11
Supplement
p. 77
October 2020.
77
ASAA
DOI: 10.48208/HeadacheMed.2020.Supplement.77
Caetano, I.; Khouri, B.; Rocha, A.; Rezende, D.; Juliani, M.; Silva, A.; Frederico, R.
Headache Medicine
Sexo feminino associado a maior chance hipersensibilidade sensorial
Igor Caetano, Bárbara Khouri, Amanda Rocha, Debora Rezende, Maria Juliani, Aline Silva, Regina Frederico
Acadêmico de Medicina da Pontifícia Universidade Católica do Paraná
Introdução
A migrânea é uma doença caracterizada por cefaleia acompanhada de hipersensibilidade sensorial como fotofobia, fonofobia,
osmofobia e alodinia. Objetivo: Investigar a associação entre a sensibilidade sensorial (alodinia, fonofobia, fotofobia e osmofobia) e
outras variáveis clínicas relacionadas a migrânea.
Métodos
Estudo observacional composto por participantes com diagnóstico de migrânea com e sem aura de ambos os sexos, com idade entre 18
a 70 anos. Foram avaliados sexo, idade, índice de massa corpórea (lMC) e etnia. Foram obtidas informações sobre tipo de migrânea
(com ou sem aura; episódica ou crônica), idade de início da doença, frequência das crises, sintomas acompanhantes e desencadeantes
de cefaleia. Os participantes responderam sobre a presença ou ausência de alodinia, fonofobia, fotofobia e osmofobia. Avaliou-
se também o grau de incapacidade da migrânea, por meio do questionário Migraine Disability Assessment (MIDAS). Os dados
categóricos foram avaliados por teste de qui-quadrado ou Exato de Fisher. Dados contínuos foram avaliados pelo teste de Mann-
Whitney. Foi considerada diferença estatística quando p<0,05
Resultados
Participaram do estudo 111 indivíduos com migrânea, destes 83,7% eram do sexo feminino, 36,9% apresentavam aura e 54,9% tinham
a forma crônica da doença. Pacientes do sexo feminino tiveram mais frequentemente alodinia (OR 1,246; p=0,009), fonofobia (OR
1,458; p=0,007) e osmofobia (OR 1,430; p<0,001). Pacientes com osmofobia tinham menor IMC comparado com os que não tinham
essa condição (24Kg/m2 Vs 28 Kg/m2; p=0,046). Pacientes com alodinia tiveram chance 70% maior de terem migrânea com aura
(OR 1,707; p=0,004) e maior quantidade de dias de cefaleia no último mês (10 dias Vs 5 dias; p=0,003) comparado com os que
não tinham alodinia. Tinham maior pontuação no MIDAS aqueles indivíduos com alodinia (26 Vs 12; p=0,001) e fonofobia (20 Vs 14;
p=0,018). O gatilho menstrual foi mais frequente entre mulheres com alodinia (OR 1,56; p= 0,041) e fotofobia (OR 1,211; p=0,012).
Odor como gatilho foi mais comum em indivíduos com alodinia (OR 1,794; p= 0,003), fonofobia(OR 1,190; p=0,027) e osmofobia (OR
1,621; p=0,002), Gatilhos alimentares ocorreram mais frequentemente entre indivíduos com osmofobia (OR 1,438; p=0,019).
Conclusão
O sexo feminino foi associado a maior chance de alodinia, fonofobia e osmofobia. A alodinia foi a manifestação de hipersensibilidade
sensorial mais associada a gravidade e a gatilhos de migrânea.
Palavras-chave: Cefaleia, Migrânea, Fotofobia, Alodinia, Hipersensibilidade sensorial