Maizels Morris
Department of Family Practice, Kaiser Permanente, Woodland Hills, California 91365, USA.
Am Fam Physician. 2004 Dec 15;70(12):2299-306.
The term "chronic daily headache" (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of refractory daily headache. A pathologic underlying cause should be considered in patients with recent-onset daily headache, a change from a previous headache pattern, or associated neurologic or systemic symptoms. Treatment of CDH focuses on reduction of headache triggers and use of preventive medication, most commonly anti-depressants, antiepileptic drugs, and beta blockers. Medication overuse must be treated with discontinuation of symptomatic medicines, a transitional therapy, and long-term prophylaxis. Anxiety and depression are common in patients with CDH and should be identified and treated. Although the condition is challenging, appropriate treatment of patients with CDH can bring about significant improvement in the patient's quality-of-life.
“慢性每日头痛”（CDH）一词描述了多种头痛类型，其中慢性偏头痛最为常见。每日头痛往往会使人丧失能力，诊断和治疗可能具有挑战性。药物过度使用或药物反弹性头痛是难治性每日头痛最可治疗的原因。对于近期出现每日头痛、头痛模式与之前不同或伴有神经系统或全身症状的患者，应考虑潜在的病理原因。CDH的治疗重点是减少头痛诱因和使用预防性药物，最常用的是抗抑郁药、抗癫痫药和β受体阻滞剂。药物过度使用必须通过停用对症药物、过渡治疗和长期预防来治疗。焦虑和抑郁在CDH患者中很常见，应予以识别和治疗。尽管这种情况具有挑战性，但对CDH患者进行适当治疗可显著改善患者的生活质量。
