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[肉毒杆菌毒素A治疗难治性偏头痛疗效的预测因素]

[Predictive factors of the response to treatment with onabotulinumtoxinA in refractory migraine].

作者信息

Pagola Inmaculada, Esteve-Belloch Patricia, Palma José Alberto, Luquin M Rosario, Riverol Mario, Martinez-Vila Eduardo, Irimia Pablo

机构信息

Clinica Universitaria de Navarra, 31008 Pamplona, Espana.

出版信息

Rev Neurol. 2014 Mar 16;58(6):241-6.

Abstract

AIM

To identify the clinical features that predict a favourable response to onabotulinumtoxinA (OnabotA) treatment in patients with refractory migraine.

PATIENTS AND METHODS

Retrospective analysis of patients with refractory migraine who underwent at least two pericranial injections of OnabotA between 2008 and 2012. Patients were divided into responders and non-responders. Some clinical features including unilateral location of headache, presence of pericranial muscle tension, type of pain (imploding or exploding), duration of migraine (less than or greater than 10 years) and medication overuse were compared between the two groups.

RESULTS

39 patients were included (35 women) with a mean age of 46 years. 18 patients (46.2%) showed a greater than 50% reduction in the number of headache days/month (responders). When analyzing the different features of migraine, we observed that all were equally prevalent in responders and non-responders (p > 0.05): unilateral location (66.7% vs 66.6% respectively), implosive pain (27.8% vs 38.1%), presence of pericranial muscle tension (33.3% vs 38.1%), duration of migraine more than 10 years (77.8% vs 69.2%) and presence of medication overuse (50% vs 81%).

CONCLUSION

We failed to identify any clinical feature in our patients with refractory migraine that predicts a favourable response to OnabotA treatment.

摘要

目的

确定可预测难治性偏头痛患者对A型肉毒毒素(OnabotA)治疗产生良好反应的临床特征。

患者与方法

对2008年至2012年间接受至少两次OnabotA颅周注射的难治性偏头痛患者进行回顾性分析。将患者分为反应者和无反应者。比较两组之间的一些临床特征,包括头痛的单侧位置、颅周肌肉紧张的存在、疼痛类型(内爆性或爆发性)、偏头痛持续时间(小于或大于10年)以及药物过度使用情况。

结果

纳入39例患者(35例女性),平均年龄46岁。18例患者(46.2%)每月头痛天数减少超过50%(反应者)。在分析偏头痛的不同特征时,我们观察到所有特征在反应者和无反应者中同样普遍(p>0.05):单侧位置(分别为66.7%和66.6%)、内爆性疼痛(27.8%和38.1%)、颅周肌肉紧张的存在(33.3%和38.1%)、偏头痛持续时间超过10年(77.8%和69.2%)以及药物过度使用的存在(50%和81%)。

结论

我们未能在难治性偏头痛患者中识别出任何可预测对OnabotA治疗产生良好反应的临床特征。

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