Migraine care in Latin America: Insights from the Latin American Headache Association (ASOLAC)
María-Karina Velez-Jimenez1, Pablo Schubaroff2, Marco Lisicki3,4 ,Mario F.P. Pérez5 , Ivy Liger5, Joe Muñoz6 , Yessika Rojas-Villegas7, Raúl Juliet8, María José López9, Ernesto Bancalari10 , María Teresa Reyes11 and Ildefonso Rodriguez-Leyva12
Abstract
Background:
Migraine affects 9.3% of Latin Americans but remains underdiagnosed and undertreated across the region.
Objective:
To examine migraine care inequities across Argentina, Brazil, Chile, Colombia, Peru, and Mexico and propose evidence-based recommendations.
Methods: We synthesized epidemiological data, healthcare system analyses, and professional society reports to compare treatment access, medical education, and care delivery models across countries. Data sources included PubMed, SciELO, WHO reports, and ASOLAC documents. The search strategy was conducted by authors from each country and covered
the period 2015–2025.
Results:
Despite high healthcare coverage (91.5–99.6%), significant care gaps exist. Neurologist-to-population ratios are critically low (1:47,000–58,000), with specialists concentrated in urban areas. Medical education provides minimal headache training (2–
4 h of undergraduate training). Triptan usage varies dramatically from 0.14% (Mexican emergency departments) to 23% (Peruvian neurologists). Anti-CGRP medications remain restricted only to private healthcare. Only 2.6% of eligible Brazilian patients receive
preventive therapy. Rural patients face wait times of 3–5 years for specialty care, compared with immediate access in the urban private sector. Emergency department utilization remains high, with 179,618 migraine-related visits in Mexico (2013–2022).
Conclusions: Despite strong healthcare coverage, migraine care requires systematic reform. Priority interventions include expanding triptan access in public systems, standardizing medical education, developing telemedicine networks, and coordinating health promotion to distinguish primary from secondary headaches. When adapted to national contexts, these strategies could substantially improve diagnosis and outcomes over the medium term.
Keywords
migraine, Latin America, healthcare inequalities, neurological care, treatment access, medical education