Uso de corticoides para tratamento de quadros agudos de enxaqueca em adultos: uma revisão sistemática

Abstract

Migraine is a primary headache with significative prevalence in the world as well as the brazilian country. It is responsable for significant costs for the health services, besides it is associated with compromising the well-being of individuals. The epidemiologic profile of migraine is well known, but the pathophysiology is complex and involve the central and peripheral nervous system, through the cortical spreading depolarization, the hypothalamic activation and the release of neuropeptides and monoamines, causing the clinical manifestations of migraine, wich can be divided in phases: premonitory, aura, cefaleia e postdrome. However is a manageable with a series of pharmacologic and non pharmacologic treatments. This study aims to evaluate the role of the corticosteroids on the treatment of the acute migraine. Therefore, was realized a systematic review with analysis and classification of the materials. The majority of the studies demonstrated that corticosteroids, primarily dexamethasone, are effective in reduce headache recurrence in the first 72 hour after discharge from emergency department. The use of corticosteroids as monotherapy to control acute symptoms related to migraine is controversial and lack studies with high level of evidence to support that use. In other words, the recommendation with higher quality of evidence indicates the use of corticosteroids as a adjunct therapy, aiming to reduce the headache recurrence after emergency department discharge.