The Epidemiology of Migraine in Medical Students Wilson Luiz Sanvito, MD; Paulo Hélio Monzillo, MD; Mário Fernando Prieto Peres; Mauro Olivio Martinelli; Melissa Patrick Fera; Daniela Alves da Cruz Gouveia; Joel Murachovsky; Wilson Roberto dos Santos Salomão; Ricardo José de Almeida Leme, MD From the Department of Neurology, Santa Casa School of Medicine, São Paulo, Brazil. Address all correspondence to Dr. Wilson Luiz Sanvito, Departamento de Neurologia, Santa Casa de Misericórdia de São Paulo, Rua Dr. Cesário Motta Jr., 112 - CEP 01277-900, São Paulo - SP Brazil. Accepted for publication October 3, 1995. The purpose of this study was to investigate the prevalence of migraine in medical students, as well as its clinical aspects and impact. All 595 medical students of Santa Casa School of Medicine of São Paulo, Brazil were asked if they had experienced any kind of headache in the past year. Those who responded positively were further investigated by an appropriate questionnaire. Diagnosis of migraine was based on the International Headache Society criteria of 1988. Forty percent of students suffer ed from some kind of headache; 40.2% of these headaches were migraine. The prevalence of migraine was 54.4% in women and 28.3% in men. Migraine headaches were unilateral in 24.2%, had a gradual onset in 69%, and were of a throbbing type in 88.3%. Mig raine was considered incapacitating by 53.9% of students. Migraine with aura caused more disability than migraine without aura. Women experienced more intense migraine than men, and migraine with aura was especially more severe than migraine without aura. Photophobia, phonophobia, and nausea were more commonly encountered in migraine with aura. Despite the high prevalence, the high rate of disability, and the need for analgesic medication, only 7.1% of students with migraine had sought medical t reatment. Key words: migraine, epidemiology, medical students ( Headache 1996;36:316–319) Headaches are the most ancient reported pain in humans. Despite being such a common complaint in medical practice, little is known about the prevalence and epidemiology of headaches in some populations. In recent years, a greater emphasis has been given to studies in this area, which have tried to shed some light onto a few of the important aspects of migraine, such as identifying the high-risk groups according to sociodemographic, genetic, and envi ronmental aspects; determining its natural history; and understanding its impact on people and society. North American studies have reported a loss of productivity up to $1 billion per year secondary to migraine. In about 10 million doctors' appointm ents, patients present migraine as their chief complaint, according to Pryse-Philips et al. 1 This represents about 4% of the total appointments per year. Andrasik and associates 2 studied the prevalence of migraine in 1200 psychology students from the University of Ohio and noticed that over half of these students reported headaches once or twice a week. Ogunyemi 3 studied the epidemiology of headache i n students from the University of Llorin in Nigeria and found that 61% of women and 59% of men reported recurrent headaches. Attanasio and Andrasik, 4 from New York University, reported that 45% of their students had weekly episodes of headaches and t hat 35% to 45% of them had their daily routine impaired. They also observed that headaches were more frequent, of greater severity, and of longer duration in women. All the above-mentioned studies analyzed headaches in general. Some focused on their clinical aspects; however, headaches were not subdivided into their different types, ie, migraine, tension headaches, and so forth. This made comparisons between the ir findings and our results difficult. Lipton and Stewart, 5 in 1993, performed an epidemiological study on migraine in the United States, where 20 468 mailed questionnaires were sent to individuals aged 12 to 80 years. Migraines were found with a prevalence of 17.6% in females and 6.0% in males. Studies on the prevalence of migraine in different Eastern and Western under-developed countries have shown that migraine is not as prevalent as in developed countries. 6,7 There seem to be no epidemiological reports from Latin America. Therefore, the objective of this research was to perform a descriptive epidemiological study of migraine in medical students analyzing the prevalence of this disease, as well as other important clinical aspects.