Torres-Ferrus M, Pozo-Rosich P
Hospitals Vall d'Hebron, 08035 Barcelona, Espana.
Rev Neurol. 2015;61 Suppl 1:S3-7.
Chronic migraine is a disease that affects 0.5-2.5% of the population, depending on the statistics that are analysed and the definition of chronic migraine that is used. It is extraordinarily disabling, since it does not allow the sufferer to carry out any of their scheduled personal, professional or social activities, and it has a great impact on the patients' quality of life, as measured on disability, quality of life and impact on daily activities scales. Yet, nowadays there are treatments that have proven to be effective in cases of chronic migraine, such as OnabotulinumtoxinA. It is a treatment that is well tolerated and with a high rate of efficacy. Yet it is not only a therapeutic tool, but in the world of headaches it has also opened up the doors to invasive treatments, to the learning of techniques and, in short, to placing headaches in referral units that are usually located in tertiary care hospitals. Furthermore, it has also helped to overcome the idea that patients with headache should be visited exclusively by primary care physicians or general neurologists. This is an opportunity to redefine the field of study and the care for headaches that must be seized. In the future, this is going to be complemented by novel treatments with neurostimulation and probably with monoclonal antibodies against the calcitonin gene-related peptide. A revolution has begun in our knowledge and capacity to act. It is our duty to give it the importance and usage it deserves both for our patients and for us as specialists.
慢性偏头痛是一种影响0.5%-2.5%人口的疾病，具体比例取决于所分析的统计数据以及所采用的慢性偏头痛定义。它极具致残性，因为患者无法进行任何预定的个人、职业或社交活动，并且从残疾程度、生活质量以及对日常活动的影响等量表来看，它对患者的生活质量有很大影响。然而，如今已有一些治疗方法在慢性偏头痛病例中被证明是有效的，比如A型肉毒杆菌毒素。这是一种耐受性良好且疗效很高的治疗方法。它不仅是一种治疗手段，而且在头痛领域还开启了侵入性治疗的大门，推动了技术学习，简而言之，促使头痛患者转诊至通常位于三级医院的专科单位。此外，它还有助于打破那种认为头痛患者只应由初级保健医生或普通神经科医生诊治的观念。这是一个必须抓住的重新定义头痛研究领域和治疗方式的契机。未来，这将由神经刺激的新型治疗方法以及可能的针对降钙素基因相关肽的单克隆抗体治疗来补充。我们在知识和行动能力方面已经开启了一场革命。我们有责任给予它应有的重视和应用，这对我们的患者以及作为专家的我们自己都很重要。
