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[慢性每日头痛——病史、流行病学、临床及未来]

[Chronic daily headache--history, epidemiology, clinic and future].

作者信息

Katarzyńska Aleksandra, Domitrz Izabela

机构信息

Katedra i Klinika Neurologii, Warszawski Uniwersytet Medyczny, ul. Banacha 1a, 02-097 Warszawa.

出版信息

Neurol Neurochir Pol. 2009 Mar-Apr;43(2):155-61.

Abstract

Chronic daily headache (CDH) is not a diagnosis but a category that contains many disorders representing primary and secondary headaches. CDH is defined as headaches which occur more often than 15 days per month for at least 3 months. Approximately 3 to 5 percent of the population worldwide has daily or near-daily headaches. Primary CDH of long duration includes transformed migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Transformed migraine and medication-overuse headaches are among the most common and challenging of the CDH disorders. Treatment of CDH focuses on reduction of headache triggers and use of preventive medications such as antidepressants, antiepileptic drugs and beta-blockers. Antidepressants are the most common preventive medications for all types of CDH, which suggests that central serotoninergic neurotransmission can be an important factor in the pathophysiology of chronic pain syndromes.

摘要

慢性每日头痛(CDH)并非一种诊断,而是一个包含许多代表原发性和继发性头痛的疾病类别。CDH被定义为每月发作超过15天且持续至少3个月的头痛。全球约3%至5%的人口患有每日或近乎每日发作的头痛。长期原发性CDH包括转化型偏头痛、慢性紧张型头痛、新发性每日持续性头痛和持续性偏侧头痛。转化型偏头痛和药物过度使用性头痛是CDH疾病中最常见且最具挑战性的类型。CDH的治疗重点在于减少头痛诱因以及使用预防性药物,如抗抑郁药、抗癫痫药和β受体阻滞剂。抗抑郁药是所有类型CDH最常用的预防性药物,这表明中枢5-羟色胺能神经传递可能是慢性疼痛综合征病理生理学中的一个重要因素。

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