Women's College Hospital Centre for Headache, Division of Neurology, University of Toronto, 76 Grenville St., Toronto, ON, M5S 1B2, Canada.
Curr Neurol Neurosci Rep. 2018 Apr 19;18(6):28. doi: 10.1007/s11910-018-0840-8.
Exercise headache refers to headache that is triggered by exercise or exertion. Although secondary causes must be excluded, most cases of exercise headache are benign, idiopathic, and self-limited. This article reviews the revised diagnostic criteria for primary exercise headache (PEH) and discusses recent research into the clinical presentation, epidemiology, pathophysiology, suggested workup, and treatment of this condition.
Recent studies estimate that PEH affects from 1 to 26% of the adult population. A secondary cause is thought to be present infrequently, but should be explored in all patients with a first or atypical presentation of exercise headache. Red flags for potential secondary causes may include older age at onset and more prolonged headache duration. There is inadequate evidence to include gender as a red flag. No recent trials have been conducted, but experts suggest that avoidance of triggers coupled with short-term NSAID and/or beta-blocker treatment may be effective for patients diagnosed with PEH. Larger studies are needed to provide high-quality evidence regarding the pathophysiology and treatment of PEH. However, recent work has shed light on the characteristics of this condition, and the ICHD-3 has provided important updates to the diagnostic criteria for this relatively common and potentially treatable condition.
运动性头痛是指由运动或用力引发的头痛。虽然必须排除继发性病因，但大多数运动性头痛为良性、特发性和自限性。本文综述了原发性运动性头痛（PEH）的修订诊断标准，并讨论了该疾病临床表现、流行病学、病理生理学、建议检查和治疗的最新研究。
最近的研究估计，PEH 影响 1%至 26%的成年人口。继发性病因很少见，但应在所有首次出现或表现不典型的运动性头痛患者中进行探索。可能的继发性病因的危险信号包括发病年龄较大和头痛持续时间较长。没有足够的证据表明性别是危险信号。最近没有进行临床试验，但专家建议，对于诊断为 PEH 的患者，避免触发因素并短期使用 NSAID 和/或β受体阻滞剂治疗可能有效。需要更大规模的研究提供关于 PEH 的病理生理学和治疗的高质量证据。然而，最近的研究工作揭示了这种疾病的特征，ICHD-3 对这种相对常见且可能可治疗的疾病的诊断标准进行了重要更新。
