Sun-Edelstein C, Bigal M E, Rapoport A M
The New York Headache Center, New York, NY 10021, USA.
Cephalalgia. 2009 Apr;29(4):445-52. doi: 10.1111/j.1468-2982.2008.01753.x.
Despite the recent advances in the understanding and classification of the chronic daily headaches, considerable controversy still exists regarding the classification of individual headaches, including chronic migraine (CM) and medication overuse headache (MOH). The original criteria, published in 2004, were difficult to apply to most patients with these disorders and were subsequently revised, resulting in broader clinical applicability. Nonetheless, they remain a topic of debate, and the revisions to the criteria have further added to the confusion. Even some prominent headache specialists are unsure which criteria to use. We aimed to explain the nature of the controversies surrounding the entities of CM and MOH. A clinical case will be used to illustrate some of the problems faced by clinicians in diagnosing patients with chronic daily headache.
尽管在慢性每日头痛的认识和分类方面最近取得了进展,但在个体头痛的分类上,包括慢性偏头痛(CM)和药物过量使用性头痛(MOH),仍然存在相当大的争议。2004年发布的原始标准难以应用于大多数患有这些疾病的患者,随后进行了修订,从而具有更广泛的临床适用性。尽管如此,它们仍然是一个争论的话题,并且标准的修订进一步增加了混乱。甚至一些著名的头痛专家也不确定该使用哪些标准。我们旨在解释围绕CM和MOH实体的争议的本质。将通过一个临床病例来说明临床医生在诊断慢性每日头痛患者时面临的一些问题。