-Background: Migraine is a chronic neurological disease with several trigger factors, including dietary, hormonal and environmental factors. Purpose: To analyse precipitating factors in a sample of migraine patients. Method: Two hundred consecutive migraine patients were interviewed about possible trigger factors for migraine attacks. Results: Most patients showed at least one dietary trigger, fasting was the most frequent one, followed by alcohol and chocolate. Hormonal factors appeared in 53% , being the pre-menstrual period the most frequent trigger. Physical activities caused migraine in 13%, sexual activities in 2.5% and 64% reported emotional stress a trigger factor. 81% related some sleep problem as a trigger factor. Regarding environmental factors, smells were reported by 36.5%. Conclusion: Trigger factors are frequent in migraine patients, its avoidance may decrease headache frequency and also improve patients' quality of life.KEY WORDS: migraine, trigger factors. fatores desencadeantes de enxaquecaResumo -Introdução: A enxaqueca é uma doença neurológica crônica que apresenta diversos desencadeantes como fatores alimentares, hormonais e ambientais. Objetivo: Analisar os fatores desencadeantes em uma amostra de pacientes com enxaqueca. Método: Duzentos pacientes com diagnóstico de enxaqueca foram questionados sobre fatores que pudessem desencadear suas crises. Resultados: 83,5% apresentaram algum fator alimentar, jejum foi o fator mais freqüente, seguido de álcool e chocolate. Dos fatores hormonais, o período pré-menstrual foi o mais freqüente. Atividade física causou enxaquecas em 13%, atividade sexual em 2,5%, estresse em 64% e 81% relataram o sono como fator desencadeante. Em relação aos fatores ambientais, odores foram desencadeantes em 36,5%. Conclusão: Os fatores desencadeantes são freqüentes em enxaqueca e a sua detecção deve ser pormenorizada para que se reduza a freqüência de crises e melhore a qualidade de vida do paciente.PAlAvRAS-cHAvE: enxaqueca, fatores desencadeantes. Migraine is a chronic debilitating neurological condition with several trigger factors. It usually begins in childhood or adolescence and can remain with the patient for the whole life. It is more common in women than men, its prevalence is 12% of the general population, affecting 18% to 20% of women, occurring mainly during their productive and reproductive phases (20 to 50 years old). Therefore, migraine has a significant socioeconomic impact and in patients quality of life 1 . Migraine is a complex disorder with several pathopsysiological mechanisms involved, such as hypothalamic dysfunction shown by a chronobiologic dysregulation, and a possible hyperdopaminergic state 2 . A variety of external and internal factors have been demonstrated to precipitate migraine attacks.Trigger factors are important in migraine management since their avoidance may result in a better control of the disorder. Several studies are consistent with stress, lack of sleep, and fasting being the most common trigger factors 3,4 , but some o...

Patients' preference regarding migraine prevention is very important in headache management. Patients rated efficacy the most important aspect in preventive therapy and preferred treatment options with higher efficacy rates. Future studies are needed for a better understanding of patients' preference for migraine prevention.

-B a c k g round: Comorbidity of chronic migraine (CM) with psychiatric disorders, mostly anxiety and mood disorders, is a well-recognized phenomenon. Phobias are one of the most common anxiety diso rders in the general population. Phobias are more common in migraineurs than non-migraineurs. The clinical profile of phobias in CM has never been studied. Method: We investigated the psychiatric profile in 56 patients with CM using the SCID I/P interview. Results: Lifetime criteria for at least one mental d i s o rder was found in 87.5% of the sample; 75% met criteria for at least one lifetime anxiety disorder and 60.7% of our sample fulfilled DSM-IV criteria for lifetime phobic avoidant disorders. Mood and anxiety s c o res were higher in phobic patients than in non-phobic CM controls. Number of phobias correlated with higher levels of anxiety and depre s s i o n . Conclusion: Phobias are common in CM. Its recognition may influence its management. Early treatment may lead to better prognosis.KEY WORDS: headache, migraine, anxiety, phobias. Fobias, outras comorbidades psiquiátricas e enxaqueca crônicaRESUMO -I n t rodução: As comorbidades psiquiátricas das enxaquecas crônicas são bem conhecidas. As fobias, transtorno ansioso mais comum, são mais prevalentes entre enxaquecosos do que entre não enxaquecosos. O perfil clínico de fobias em uma população enxaquecosa nunca foi estudado. M é t o d o : Estudamos aspectos psiquiátricos de uma população de 56 pacientes com enxaqueca crônica. R e s u l t a d o s :Usando o SCID I/P para o DSM-IV, critérios diagnósticos para ao menos algum transtorno psiquiátrico durante a vida foram preenchidos por 87,5% de nossa amostra, 75% para ao menos um transtorno ansioso e 60,7% para condições fóbicas em algum momento de suas vidas. Os escores de ansiedade e humor foram maiore s e n t re os fóbicos e o número de fobias teve correlação positiva com o grau de ansiedade e depre s s ã o . Conclusão: Fobias são comuns na enxaqueca crônica e seu reconhecimento poderia influenciar seu manejo e melhorar seu prognóstico.

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