Miller Sarah, Matharu Manjit
Headache Group, Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
Curr Pain Headache Rep. 2014;18(8):438. doi: 10.1007/s11916-014-0438-z.
The trigeminal autonomic cephalalgias include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. While the majority responds to conventional pharmacological treatments, a small but significant proportion of patients are intractable to these treatments. In these cases, alternative choices for these patients include oral and injectable drugs, lesional or resectional surgery, and neurostimulation. The evidence base for conventional treatments is limited, and the evidence for those used beyond convention is more so. At present, the most evidence exists for nerve blocks, deep brain stimulation, occipital nerve stimulation, sphenopalatine ganglion stimulation in chronic cluster headache, and microvascular decompression of the trigeminal nerve in short-lasting unilateral neuralgiform headache attacks.
三叉神经自主性头痛包括丛集性头痛、发作性偏侧头痛、短暂性单侧神经痛样头痛发作和持续性偏侧头痛。虽然大多数患者对传统药物治疗有反应，但仍有一小部分但比例可观的患者对这些治疗无效。在这些情况下，这些患者的替代选择包括口服和注射药物、损伤性或切除性手术以及神经刺激。传统治疗的证据基础有限，而非常规使用的治疗方法的证据更是如此。目前，关于神经阻滞、深部脑刺激、枕神经刺激、慢性丛集性头痛中的蝶腭神经节刺激以及短暂性单侧神经痛样头痛发作中的三叉神经微血管减压术的证据最多。
