Göbel H, Heinze A, Heinze-Kuhn K, Jost W H
Kiel Pain Clinic, Heikendorfer Weg 9-27 D-24149 Kiel, Germany.
J Neurol. 2001 Apr;248 Suppl 1:34-8. doi: 10.1007/pl00007818.
The therapeutic effect of botulinum toxin in headache was observed coincidentally. The rationale for this new indication initially met with a great deal of scepticism, because the toxin's mechanism of action, cholinergic chemodenervation, does not fit the pathophysiological concept of migraine and other forms of headache. Meanwhile a fair number of studies have been published which indicate efficacy for botulinum toxin and recommend its use for the treatment of tension headache and migraine. According to the evidence-based medicine criteria, grade I evidence has been demonstrated. In addition the use of botulinum toxin for cluster-headache and secondary headache is discussed. Further large scale studies will be regarded to demonstrate the long-term efficacy.
肉毒杆菌毒素在头痛治疗中的疗效是偶然被观察到的。这一新适应症的理论依据最初遭到了诸多怀疑，因为该毒素的作用机制——胆碱能化学去神经支配，并不符合偏头痛和其他类型头痛的病理生理概念。与此同时，已经发表了相当多的研究，表明肉毒杆菌毒素具有疗效，并推荐将其用于治疗紧张性头痛和偏头痛。根据循证医学标准，已证实为一级证据。此外，还讨论了肉毒杆菌毒素在丛集性头痛和继发性头痛治疗中的应用。还需要进一步的大规模研究来证明其长期疗效。
