丛集性头痛的治疗困境：专家回应。

Cluster headache treatment dilemmas: the experts respond.

作者信息

Loder Elizabeth, Rizzoli Paul, McGeeney Brian, Ward Thomas, Levin Morris, Shapiro Robert E, Tepper Stewart, Newman Larry, Sheftell Fred, Rapoport Alan, Markley Herbert

机构信息

1153 Centre Street, Boston, MA 02130, USA.

出版信息

Curr Pain Headache Rep. 2007 Apr;11(2):141-7. doi: 10.1007/s11916-007-0012-z.

DOI:10.1007/s11916-007-0012-z

PMID:17367594

Abstract

When conventional treatment approaches to cluster headache are unsuccessful, expert recommendations are relevant but may not be easily accessible to treating clinicians. We conducted a study of expert recommendations in response to standardized vignettes. Ten expert headache clinicians were asked what treatment they would recommend for a hypothetical 55-year-old male cluster headache patient in the following five situations: 1) known coronary artery disease with response only to sumatriptan; 2) strictly unilateral headaches unresponsive to preventive treatment; 3) effective abortive treatment not covered by insurance; 4) patient request to obtain methysergide from Canada; and 5) headaches responsive only to steroid treatment.

摘要

当丛集性头痛的传统治疗方法未取得成功时，专家建议虽有参考价值，但临床治疗医生可能难以轻易获取。我们针对标准化病例摘要开展了一项专家建议研究。我们询问了十位头痛专家临床医生，对于以下五种情况下一位假设的55岁男性丛集性头痛患者，他们会推荐何种治疗方法：1）已知患有冠状动脉疾病，仅对舒马曲坦有反应；2）严格单侧头痛，对预防性治疗无反应；3）有效的终止性治疗不在保险覆盖范围内；4）患者要求从加拿大获取麦角酰二乙胺；5）头痛仅对类固醇治疗有反应。