Meienberg O
Praxis für Neurologie, Binningen.
Ther Umsch. 2006 Mar;63(3):205-10. doi: 10.1024/0040-5930.63.3.205.
Medication overuse headache (MOH) occurs in about 1% of the general population. A marked increase of its prevalence has to be expected in the future, since more and more adolescents are subject to medication overuse. The revised International Classification of Headache Disorders contains detailed diagnostic criteria for headache due to particular groups of substances. They help recognizing MOH due to ergots, triptans, analgesics and opioids, and to distinguish them from each other MOH almost exclusively occurs in patients with a long history of migraine or chronic tension type headache, which suggests some genetic disposition. The treatment of choice of MOH is withdrawal of the causing drug. Long-term treatment for headache is ineffective during medication overuse. Relapse rate is variable depending on the substance overused, and may be considerable. Therefore, prophylaxis in patients with migraine or chronic tension type headache who do not yet suffer from MOH, is essential.
药物过度使用性头痛(MOH)在普通人群中的发生率约为1%。由于越来越多的青少年存在药物过度使用的情况,预计其患病率在未来将显著上升。修订后的《国际头痛疾病分类》包含了特定药物组所致头痛的详细诊断标准。这些标准有助于识别麦角胺、曲坦类药物、镇痛药和阿片类药物所致的药物过度使用性头痛,并将它们相互区分开来。药物过度使用性头痛几乎仅发生在有偏头痛或慢性紧张型头痛病史较长的患者中,这提示存在某种遗传易感性。药物过度使用性头痛的首选治疗方法是停用致病药物。在药物过度使用期间,长期使用治疗头痛的药物无效。复发率因过度使用的药物而异,可能相当高。因此,对尚未患药物过度使用性头痛的偏头痛或慢性紧张型头痛患者进行预防至关重要。