Triggers, symptoms, and treatment in two populations of migraneurs in Brazil and Spain. A cross-cultural study

J Neurol Sci. 2011 May 15;304(1-2):25-8. doi: 10.1016/j.jns.2011.02.027. Epub 2011 Mar 12.


Background and aim: Cultural variation in pain and headache presentation may exist. The objective of this study was to assess cross-cultural differences in the use of drugs commonly managed to treat and prevent migraine, and to analyze the awareness about symptoms and triggers between two populations of migraneurs in Brazil and Spain.

Methods: International cross-cultural study. Patients answered a socio-demographic questionnaire that included questions about trigger factors, and use of drugs to treat and prevent migraine attacks.

Results: 292 patients (mean age 34.6 years; 80% females) were included in the study. Most common identified triggers in Brazilian and Spanish patients were: food (30.5% vs 12.6%), sleep (56.7% vs 28.5%), odors (52.5% vs 9.3%), stress (73.1% vs 46.4%), and menstrual period (55.6% vs 38.1%), all p<0.01. Analgesics and anti-inflammatory drugs were the most commonly used drugs to treat migraine attacks. Brazilian migraneurs used less commonly triptans (16.3% vs 47%; p<0.0001). Prophylactic drugs were used less frequently in Brazil than in Spain (21.9% vs 52.9%; p<0.0001). Calcium-antagonists, tricyclic anti-depressives, beta-blockers, and anti-epileptic drugs were significantly more used in Spanish migraineurs (p<0.01).

Conclusions: Brazilians migraneurs are more often undertreated for migraine, and underutilization of triptans and preventatives was observed.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Brazil / ethnology
  • Cross-Cultural Comparison*
  • Female
  • Humans
  • Internationality
  • Male
  • Middle Aged
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / ethnology*
  • Population Surveillance* / methods
  • Prospective Studies
  • Spain / ethnology
  • Surveys and Questionnaires
  • Treatment Outcome
  • Tryptamines / therapeutic use
  • Young Adult


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tryptamines