Samton Julia, Mauskop Alexander
New York Headache Center, New York, NY 10021, USA.
Expert Rev Neurother. 2006 Mar;6(3):313-22. doi: 10.1586/14737175.6.3.313.
Primary headache disorders, such as migraine, chronic daily headache (CDH), and chronic tension-type headache (CTTH), are some of the most frequent disorders encountered by physicians in the outpatient setting. Chronic headache disorders cause significant morbidity and functional impairment. Despite important advances in both pharmacological and behavioral management of headache disorders, a number of patients remain treatment resistant. Botulinum toxin (BT) is emerging as a new therapeutic alternative in the preventative treatment of headaches. BT has several advantages over current prophylactic strategies, such as reduced side-effect profile and improved patient compliance. Furthermore, there have been several studies supporting the safety and tolerability of BT in the treatment of headache disorders. Although additional large-scale studies are needed to clarify clinical predictors of response as well as optimal dosing, injection sites and mechanism of action, BT has demonstrated efficacy in the treatment of migraines and CDH. The evidence for the treatment for CTTH is less compelling.
原发性头痛疾病，如偏头痛、慢性每日头痛（CDH）和慢性紧张型头痛（CTTH），是门诊医生遇到的最常见的疾病之一。慢性头痛疾病会导致严重的发病率和功能障碍。尽管在头痛疾病的药物治疗和行为治疗方面都取得了重要进展，但仍有许多患者对治疗有抵抗性。肉毒杆菌毒素（BT）正在成为头痛预防性治疗的一种新的治疗选择。与目前的预防性策略相比，BT有几个优点，如副作用减少和患者依从性提高。此外，有几项研究支持BT在治疗头痛疾病方面的安全性和耐受性。虽然需要更多的大规模研究来明确反应的临床预测因素以及最佳剂量、注射部位和作用机制，但BT已证明在治疗偏头痛和CDH方面有效。治疗CTTH的证据不那么有说服力。
