Lenaerts Marc E, Green Tiffany H
Department of Neurology, University of California, Davis, 4160, Y St., No. 3700, Sacramento, CA, 95817, USA.
Curr Treat Options Neurol. 2019 Apr 4;21(4):21. doi: 10.1007/s11940-019-0561-6.
The role of onabotulinumtoxinA in headache management was serendipitously found over a decade ago and approved for chronic migraine in 2010 based on pivotal studies. The purpose of this review is to highlight the impact on headache and other health parameters which is critically reviewed, as well as the putative mechanisms of action.
OnabotulinumtoxinA is effective in migraine, not only headache frequency and pain intensity but also other health parameters including quality of life. Tolerability is high and benefit/cost analysis is favorable. It should be considered off-label in refractory trigeminal neuralgia and post-herpetic neuralgia but further research in these areas. Ongoing investigation of onabotulinumtoxinA in cluster headache is too preliminary for recommendation of use but promising. Recent and future developments in other headache disorders are discussed. OnabotulinumtoxinA has been approved for migraine almost a decade ago and been proven beneficial not only on headache parameters but other health outcomes. Its role as adjuvant is being studied and emerging in other headache syndromes.
十余年前偶然发现了A型肉毒毒素（onabotulinumtoxinA）在头痛治疗中的作用，并于2010年基于关键研究被批准用于慢性偏头痛。本综述的目的是强调其对头痛及其他健康参数的影响，并对其作用机制进行批判性综述。
A型肉毒毒素对偏头痛有效，不仅能减少头痛发作频率和疼痛强度，还能改善包括生活质量在内的其他健康参数。耐受性良好，效益成本分析结果有利。在难治性三叉神经痛和带状疱疹后神经痛中，应考虑其超说明书用药，但这些领域还需进一步研究。目前对A型肉毒毒素在丛集性头痛中的研究尚处于初步阶段，虽有前景但还不适合推荐使用。文中还讨论了其他头痛疾病的近期及未来进展。A型肉毒毒素近十年前已被批准用于偏头痛治疗，且已证明其不仅对头痛参数有益，对其他健康指标也有改善作用。其作为辅助治疗在其他头痛综合征中的作用正在研究中且逐渐显现。
