Chronic Migraine Treatment in Recife
Chronic migraine is a debilitating condition affecting millions. At Intrador, we offer preventive treatment with botulinum toxin, occipital nerve blocks, and medical acupuncture with headache specialists in Recife.
What is Chronic Migraine?
Chronic migraine is defined by the International Headache Society (IHS) as:
- • 15 or more headache days per month
- • For at least 3 consecutive months
- • On 8 or more of these days, the pain has migraine characteristics
Approximately 1-2% of the global population suffers from chronic migraine, with 75% of cases in women. The condition significantly impacts quality of life, work, and social relationships.
Symptoms and Characteristics
Migraine Attack Symptoms
- Intense throbbing (pulsating) pain
- Usually unilateral (one side of the head)
- Duration of 4 to 72 hours if untreated
- Nausea and/or vomiting
- Photophobia (light sensitivity)
- Phonophobia (sound sensitivity)
- Worsens with physical activity
Migraine with Aura (30% of cases)
Transient neurological symptoms preceding pain:
- Visual disturbances (blind spots, zig-zags)
- Unilateral tingling
- Temporary speech difficulty
- Weakness on one side of the body
- Duration: 5 to 60 minutes
Migraine Triggers
Dietary
- • Chocolate
- • Aged cheeses
- • Red wine
- • Excess caffeine
- • Monosodium glutamate
- • Prolonged fasting
Environmental
- • Bright or flashing lights
- • Strong smells (perfumes)
- • Weather changes
- • Altitude
- • Excessive noise
Behavioral
- • Emotional stress
- • Sleep deprivation
- • Excessive sleep
- • Intense exercise
- • Hormonal changes
Treatments for Chronic Migraine at Intrador
Our approach focuses on crisis prevention using robust scientific evidence techniques:
Botulinum Toxin (Botox) for Chronic Migraine
Approved by Anvisa and FDA as first-line preventive treatment for chronic migraine:
- 31 fixed injection sites on head, neck, trapezius, and forehead
- Reapplication every 3 months (PREEMPT protocol)
- Proven efficacy: 50% reduction in crisis frequency in 70% of patients
- Reduction in headache days: average of 8-9 fewer days per month
- Cumulative improvement: benefit increases with successive cycles
Outpatient procedure, 15-20 minutes duration, no anesthesia needed. Effect starts in 7-10 days.
PREEMPT 1 and 2 Studies: Randomized, double-blind, placebo-controlled studies with 1,384 patients proved efficacy and safety of botulinum toxin for chronic migraine.
Occipital Nerve Blocks
Guided infiltration of local anesthetic and corticosteroid in greater and lesser occipital nerves:
- Immediate relief in refractory crises
- Preventive effect for weeks to months
- Outpatient procedure, 10 minutes
- Can be combined with botulinum toxin
Preventive Medical Acupuncture
Acupuncture is recognized by the American Academy of Neurology as an effective preventive treatment for migraine:
- 50% reduction in crisis frequency
- Decrease in pain intensity
- Less need for rescue medication
- Protocol: 10-12 weekly sessions, monthly maintenance
Preventive Medications
Daily medications for prevention (prescribed by the specialist):
- Beta-blockers: propranolol, metoprolol
- Anticonvulsants: topiramate, valproic acid
- Antidepressants: amitriptyline, venlafaxine
- Anti-CGRP monoclonal antibodies: erenumab, galcanezumab (new generation)
Difference between Migraine and Tension Headache
| Characteristic | Migraine | Tension Headache |
|---|---|---|
| Pain Type | Pulsating/throbbing | Tightness/pressure |
| Location | Unilateral (one side) | Bilateral (two sides) |
| Intensity | Moderate to severe | Mild to moderate |
| Nausea/Vomiting | Present | Absent |
| Photophobia/Phonophobia | Present | Absent or mild |
| Worsens with activity | Yes | No |
Frequently Asked Questions about Chronic Migraine
What is chronic migraine?
Chronic migraine is defined as 15 or more headache days per month for at least 3 months, with 8 or more of those days having migraine characteristics. It is a disabling condition requiring specialized preventive treatment.
Does botulinum toxin work for migraine?
Yes. Botulinum toxin (Botox) is approved by Anvisa and FDA for preventive treatment of chronic migraine. Studies show a 50% reduction in crisis frequency in over 70% of patients. Treatment consists of 31 specific injections in the head, neck, and shoulders every 3 months.
What is the difference between migraine and tension headache?
Migraine is a pulsating headache, usually unilateral, moderate to severe intensity, worsened by physical activity and associated with nausea, vomiting, photophobia, and phonophobia. Tension headache is a tightening/pressing pain, bilateral, mild to moderate intensity, without nausea or worsening with physical activity.
Is there a cure for migraine?
Migraine has no definitive cure but can be effectively controlled with appropriate preventive treatment. Botulinum toxin, acupuncture, occipital nerve blocks, and preventive medications can drastically reduce crisis frequency and intensity, improving quality of life.
Schedule Appointment with Migraine Specialist
Stop suffering from chronic migraine. Our headache specialist physicians in Recife offer preventive treatment based on scientific evidence.
Aflitos Unit
Av. Conselheiro Rosa e Silva, 1206, Room 706 - Espinheiro, Recife - PE, ZIP 52020-220
+55 (81) 3072-9816Service hours: Monday to Friday, 8am to 6pm
💡 Botulinum Toxin Covered by Insurance
Botulinum toxin treatment for chronic migraine may be covered by health plans like SulAmérica and Cassi. Consult our team to verify coverage.
Clinical Review
Dr. José Luiz de Miranda Coelho Inojosa
Neurologist | CRM/PE 15953
Head of Demyelinating Diseases Ambulatory (HC-UFPE)
Clinically Reviewed by:
Dr. José Luiz M. C. Inojosa
Neurologia
CRM-PE 15953 | RQE 9769
This content is informative and does not replace individual medical evaluation.
See full credentials
Physician specializing in Neurology and Acupuncture. His dual training allows for a differentiated approach in the care of nervous system diseases.
Note: This content is for educational and informational purposes only. The information is based on scientific evidence and the clinical practice of the Intrador team, but it does not replace individualized medical evaluation. Conduct, indications, and treatments must be defined after medical consultation.
Clinical reviewer: Dr. Helio Widson Alves Pinheiro · Pain Medicine | Acupuncture · CRM/PE 21167 | RQE 2217, 2808
Published on: January 17, 2026
Reviewed on: January 29, 2026
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