Botulinumtoxin bei Kopfschmerzen: Ende eines langen Weges?

Straube, Andreas

doi:10.1055/s-0030-1248609

Akt Neurol

2010

DOI: 10.1055/s-0030-1248609

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Botulinumtoxin bei Kopfschmerzen: Ende eines langen Weges?

Andreas Straube¹

Abstract: Keywords• " onabotulinumtoxin A • " abobotulinumtoxin A • " chronic migraine • " tension-type headache • " episodic migraine Bibliografie DOI http://dx.

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Cited by 3 publications

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Diagnose und Therapie des Kopfschmerzes vom Spannungstyp

Straube¹

2014

Bundesgesundheitsbl.

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Episodic headache of the tension type is the most prevalent primary headache with a lifetime prevalence of about 78 %. Clinical characteristics are a dull, moderate, holocephalic headache without accompanying autonomic or vegetative symptoms. The episodic tension-type headache often lasts only 30 min up to a maximum of a few days. In contrast to this clinically often undemanding headache, chronic tension-type headache can cause considerable disability in patients. The 1-year prevalence is 1-3 % of the population. All therapy strategies combine nonpharmaceutical therapy such as education of the patient, regular aerobic exercise, and psychological treatment (e.g., Jacobson's progressive muscle relaxation etc.) with pharmaceutical treatment such as tricyclic antidepressants or combined serotonergic and noradrenergic antidepressants. Combination therapy has been proven to be more effective than singular strategies; however, the chronic tension-type headache still poses a therapeutic problem.

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Diagnose und Therapie des Kopfschmerzes vom Spannungstyp

Straube¹

2014

Bundesgesundheitsbl.

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Therapie und Versorgung bei chronischer Migräne

et al. 2012

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Chronic migraine (CM) was first defined in the second edition of the International Headache Society (IHS) classification in 2004. The definition currently used (IHS 2006) requires the patient to have headache on more than 15 days/month for longer than 3 months and a migraine headache on at least 8 of these monthly headache days and that there is no medication overuse. In daily practice the majority of the patients with CM also report medication overuse but it is difficult to determine whether the use is the cause or the consequence of CM. Most the patients also have other comorbidities, such as depression, anxiety and chronic pain at other locations. Therapy has to take this complexity into consideration and is generally multimodal with behavioral therapy, aerobic training and pharmacotherapy. The use of analgesics should be limited to fewer than 15 days per month and use of triptans to fewer than 10 days per month. Drug treatment should be started with topiramate, the drug with the best scientific evidence. If there is no benefit, onabotulinum toxin A (155-195 Units) should be used. There is also some limited evidence that valproic acid and amitriptyline might be beneficial. Neuromodulation by stimulation of the greater occipital nerve or vagal nerve is being tested in studies and is so far an experimental procedure only.

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Kopfschmerz vom Spannungstyp

Straube

Förderreuther

Eren

2020

Schmerz

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Botulinumtoxin bei Kopfschmerzen: Ende eines langen Weges?

Abstract: Keywords• " onabotulinumtoxin A • " abobotulinumtoxin A • " chronic migraine • " tension-type headache • " episodic migraine Bibliografie DOI http://dx.

Cited by 3 publications

References 18 publications

Diagnose und Therapie des Kopfschmerzes vom Spannungstyp

Diagnose und Therapie des Kopfschmerzes vom Spannungstyp

Therapie und Versorgung bei chronischer Migräne

Kopfschmerz vom Spannungstyp

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