Fumal A, Gérardy P Y, Schoenen J
Service Uni- versitaire de Neurologie, Unité de Recherches sur les Céphalées, Hôpital de la Citadelle, Liège, Belgique.
Rev Med Liege. 2008 May-Jun;63(5-6):315-29.
Despite its high prevalence and individual as well as societal burden, migraine remains underdiagnosed and undertreated. In recent years, the options for the management of migraine patients have greatly expanded. A number of drugs belonging to various pharmacological classes and deliverable by several routes are now available both for the acute and the preventive treatments of migraine. Nevertheless, disability and satisfaction remain low in many subjects because treatments are not accessible, not optimized, not effective or simply not tolerated. There is thus still considerable room for better education and for more efficient therapies. In spite of useful internationally accepted guidelines, anti-migraine treatment has to be individually tailored to each patient taking into account the migraine subtype, the ensuing disability, the patient's previous history and present expectations, and the comorbid disorders. In this article we will summarize the phenotypic presentations of migraine and review recommendations for acute and preventive treatment, highlighting recent advances which are relevant for clinical practice in terms of both diagnosis and management.
尽管偏头痛患病率高,且给个人和社会带来负担,但仍存在诊断不足和治疗不充分的情况。近年来,偏头痛患者的管理选择有了很大扩展。现在有多种属于不同药理学类别的药物,可通过多种途径给药,用于偏头痛的急性治疗和预防性治疗。然而,许多患者的残疾程度和满意度仍然较低,原因是治疗无法获得、未优化、无效或根本无法耐受。因此,在更好的教育和更有效的治疗方面仍有很大空间。尽管有国际认可的有用指南,但抗偏头痛治疗必须根据每位患者的情况进行个体化调整,要考虑偏头痛亚型、随之而来的残疾、患者既往史和当前期望以及合并症。在本文中,我们将总结偏头痛的表型表现,并回顾急性和预防性治疗的建议,重点介绍在诊断和管理方面与临床实践相关的最新进展。