Research Submission Clinical Characteristics and Patterns of Medication Use of Migraneurs in Latin America From 12 Cities in 6 Countries Luis E. Morillo, MD, MSc; Fernando Alarcon, MD; Nayesca Aranaga, MD; Sara Aulet, MD, MSc; Evelina Chapman, MD, MSc; Lucien Conterno, MD, PhD; Edmundo Estevez, MD; Felipe Garcia-Pedroza, MD, MPH; Juanita Garrido; Miguel Macias-Islas; Paulo Monzillo; Lilia Nunez; Noel Plascencia; Carlos Rodriguez; Yuri Takeuchi for the Latin American Migraine Study Group Objective.—The objective of this study was to document the clinical characteristics of migraine and patterns of medication use in residents ≥15 years old in 12 Latin American urban communities. Background.—Few large-scale population studies have established the symptoms and disability associated with migraine with or without aura in Latin American urban communities or the pattern of medication use in these regions. Methods.—In this study, subjects in 12 urban communities, from 6 Latin American countries, were surveyed with a validated face-to-face interview questionnaire based on International Headache Society criteria for migraine. The questionnaire was completed during face-to-face interviews with headache sufferers within selected households and included questions about migraine symptoms, migraine-related disability, and the use of health-care resources and medications to treat migraines. Results.—Of the 8618 people available for screening, 62% suffered from headaches. Of individuals with mi- graine, 42% reported consulting a health-care professional about their headaches. Of the migraineurs, 94.2% reported moderate to severe pain. Associated symptoms of nausea or vomiting, photophobia, phonophobia, and osmophobia were common during migraine attacks in 30.3, 76.4, 85.1, and 47.7% of subjects, respectively. The majority of subjects suffered between one and eight migraines each month. Although no previous diagnosis of migraine was reported by 65% of headache sufferers, migraineurs lost an average of 8 days in the preceding 3 months in any of the following areas: school, work, household chores, and/or social, family, or leisure activities. The agents used most widely to treat migraine were paracetamol and salicylates, while nonsteroidal anti-inflammatory drugs, dypirone, and ergotamines were also commonly used. Medication use varied widely among countries, but was predominantly nonprescription. Conclusions.—Migraine is a common disorder in Latin American urban communities imposing significant burden on individuals, families, and communities. The magnitude of the impact and the range of activities affected by migraine are similar to those of previous reports in other regions. The preponderance of nonprescription medications and the scarcity of migraine-specific triptans from the study findings are especially striking. Key words: migraine, cultural, Latin American, treatment, disability Abbreviations: NSAIDs nonsteroidal anti-inflammatory drugs, IHS International Headache Society, MIDAS migraine disability assessment scale (Headache 2005;45:118-126) From the Neuroscience Department-Neurology Unit, Hospital Universitario de San Ignacio, Bogota, Colombia (Dr. Morillo); Hospital Eugenio Espejo, Servicio de Neurologia, Quito, Ecuador (Dr. Alarcon); Universidad Central de Venezuela, Caracas, Venezuela (Drs. Aranaga and Garrido); Universidad Nacional de Tucuman, Unidad de Epidemiologia Clinica, Tucuman, Argentina (Drs. Aulet and Chapman); Medicine School of Marilia, Marilia, Brazil (Drs. Conterno and Rodriguez); Instituto de la Comunicacion Humana, Mexico DF, Mexico (Dr. Garcia-Pedroza); CMN de Occidente del IMSS, Guadalajara, Mexico (Dr. Macias-Islas); Headache Center Hospital Santa Casa Misericordia Sao Pablo, Sao Paulo, Brazil (Dr. Monzillo); Servicio de Neurolog´ ıa Adultos CMN 20 de Noviembre, Mexico DF, Mexico (Drs. Nunez and Plascencia); Fundacion Clinica Valle del Lili, Cali, Colombia (Dr. Takeuchi). Address all correspondence to Dr. Luis E. Morillo, email: lmorillo@javeriana.edu.co. Accepted for publication September 26, 2004. 118