Barolin G S
Ludwig-Boltzmann-Institut für Neuro-Rehabilitation und -Prophylaxe, Landes-Nervenkrankenhauses Valduna, Rankweil.
Wien Med Wochenschr. 1992;142(19):439-43.
Paroxysmal headache of the migraine type as well as permanent undulating headache (which we call cephalea) can lead to chronification, both often mixes within the chronification. Existence of psychogenic factors (in the broader sense) favourises chronification of headache. A self supporting circulus vitiosus may arise, in combination with the cervical column, depressivity, whiplash-injury, chronical over-use of drugs (often not without an iatrogenic component), expertise situations. Therapeutically we emphasise a polypragmasy orientated on target-symptoms. Analgesics and tranquilizers want to be excluded as much as possible. Clearly indicated antidepressant are of great value, physiotherapy and psychotherapy as well. As ultima ratio we administer a neuroleptic sleeping cure.
偏头痛型的阵发性头痛以及持续性波动性头痛（我们称之为头痛症）都可能导致慢性化，两者在慢性化过程中常常相互交织。心理因素（从广义上讲）会促使头痛慢性化。可能会出现一个自我维持的恶性循环，它与颈椎问题、抑郁症、挥鞭样损伤、长期过度使用药物（往往存在医源性因素）、专业检查情况等有关。在治疗方面，我们强调针对目标症状的综合治疗。应尽可能避免使用镇痛药和镇静剂。明确适用的抗抑郁药具有重要价值，物理治疗和心理治疗也同样如此。作为最后的手段，我们会采用抗精神病药物进行睡眠治疗。
