• Peres Mario Fernando Prieto MFP http://orcid.org/0000-0002-0068-1905 Hospital Israelita Albert Einstein, São Paulo, Brazil. Instituto de Psiquiatria, , Diego Belandrino Swerts, Arão Belitardo de Oliveira, and Raimundo Pereira Silva-Neto.
• Hospital Israelita Albert Einstein, São Paulo, Brazil. Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da USP, Rua Joaquim Eugênio de Lima, 881 cj 708, Sao Paulo, SP, Brazil. mariop3r3s@gmail.com.
• J Headache Pain. 2019 Aug 15; 20 (1): 88.

BackgroundMigraine diagnosis is based on clinical aspects and is dependent on the experience of the attending physician. This study aimed to describe the patients journey profile until they start their experience in a tertiary headache center.MethodsIn a cross-sectional study, medical charts from migraine patients were reviewed to describe which treatments, procedures and follow-up strategies are performed until the first appointment with a headache specialist. Patients from both sexes, ≥18 years old, which came to their first visit from March to July 2017 were included. Sociodemographic information, headache characteristics, diagnostic methods previously used, clinical history, family history and the treatments previously used were assessed in the first appointment with a specialist. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were also applied. Descriptive analyses were performed to describe the sample profile and statistical tests were used to evaluate factors associated with the type of migraine (chronic or episodic).ResultsThe sample consisted of 465 patients. On average, the pain started 17.1 (SD = 11.4) years before the first appointment with a headache specialist. Most of patients were classified as having chronic migraine (51.7%), with an average frequency of 15.5 (SD = 9.9) days per month. Regarding patients' journey until a specialist, most patients were submitted to laboratory tests (74.0%), cranial tomography (66.8%) and magnetic resonance imaging (66.8%) as diagnostic methods, and preventive drugs (70.2%) and acupuncture (61.0%) as treatments. After stratification by migraine type as episodic or chronic, patients with chronic migraine were submitted to more magnetic resonance imaging test, acupuncture, psychotherapy, used preventive drugs, and reported to have used topiramate without beneficial effects.ConclusionsBrazilian patients with migraine experiment a long journey until getting to a headache specialist and are submitted to a great number of unnecessary exams, especially those with chronic migraine.

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