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[药物过量使用性头痛]

[Medication-overuse headache].

作者信息

Pijpers J A, Wiendels N J, Koppen H, Ferrari M D, Haan J, Terwindt G M

机构信息

Leids Universitair Medisch Centrum, afd. Neurologie, Leiden.

出版信息

Ned Tijdschr Geneeskd. 2018;162:D1749.

Abstract
  • Medication-overuse headache is a highly prevalent disorder with a major impact on the quality of life.- Medication-overuse headache is defined as headache on ≥ 15 days per month with overuse of acute headache medication for ≥ 3 months. We talk about overuse in case of intake of simple analgesics on ≥ 15 days per month or triptans or combinations of analgesics on ≥ 10 days per month.- The underlying type of headache is usually migraine or tension-type headache.- One of the possible underlying mechanisms of medication-overuse headache is changed sensitivity as a consequence of central sensitisation.- The initial treatment is detoxification of the headache medication. The preferred detoxification method is outpatient, abrupt withdrawal of all acute-headache medication and caffeine-containing products. Essential for successful detoxification is education about the reasons for detoxification, the expected course and the subsequent treatment.
摘要
  • 药物过度使用性头痛是一种非常普遍的疾病,对生活质量有重大影响。

  • 药物过度使用性头痛的定义为每月≥15天出现头痛,且急性头痛药物过度使用≥3个月。如果每月服用单纯镇痛药≥15天,或每月服用曲坦类药物或镇痛药组合≥10天,我们就称之为过度使用。

  • 潜在的头痛类型通常为偏头痛或紧张型头痛。

  • 药物过度使用性头痛可能的潜在机制之一是中枢敏化导致的敏感性改变。

  • 初始治疗是停用头痛药物。首选的戒毒方法是门诊治疗,突然停用所有急性头痛药物和含咖啡因的产品。成功戒毒的关键是对戒毒原因、预期过程和后续治疗进行教育。

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