Resumen
Introducción: la cefalea crónica refractaria genera una alteración importante en la calidad de vida de los pacientes y solo una minoría logra avanzar en el tratamiento hacia el uso de toxina botulínica o anticuerpos monoclonales anti-CGRP (siglas en inglés para péptido relacionado con el gen de la calcitonina). El propósito del estudio es evaluar la eficacia y adherencia de una dieta específica en el control de este tipo de cefalea.
Materiales y métodos: estudio experimental no controlado. Un total de 24 pacientes con cefalea crónica (?15 días al mes) y refractaria (fallo a ?3 preventivos), mayores de 18 años, realizaron una dieta basada en la eliminación de gatillos, libre de gluten y de bajo índice glucémico, con un agregado progresivo de alimentos según tolerancia. El objetivo primario fue la reducción en más del 50,0?% de la frecuencia mensual de cefalea y el secundario fue la adherencia (medida por el número de transgresiones alimentarias y el tiempo total en dieta).
Resultados: el objetivo primario se alcanzó en el 83,0?% de los pacientes (p <0,001), dentro de los cuales el 55,0?% logró una reducción de la frecuencia de cefalea entre el 50,0-80,0?%, el 35,0?% entre el 81,0-99,0?% y el 10,0?% quedó libre de cefaleas. El 17,0?% tuvo una adherencia muy buena a la dieta, el 58,0?% buena y el 25,0?% regular, con una media de uso de dos meses en quienes no funcionó y mayor a tres meses para los que les fue efectiva.
Discusión: la estructura de la dieta, además de lograr una eficacia apreciable en un tiempo razonable, permitió la flexibilización de la misma considerando los gustos y la tolerancia del paciente.
Conclusiones: esta estrategia dietaria podría ser una opción prometedora para el tratamiento de las cefaleas crónicas refractarias.
Citas
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