Department of Neurology, NIMHANS, Bengaluru, Karnataka, India.
Department of Neurology, St. Johns Medical College Hospital, Bengaluru, Karnataka, India.
Neurol India. 2021 Mar-Apr;69(Supplement):S76-S82. doi: 10.4103/0028-3886.315981.
Medication overuse headache (MOH) is one of the highly disabling headache disorder and affects about 1% of the population of the world. It is associated with the development of headache for 15 days or more, with consumption of acute symptomatic medications for 10-15 days (depending on the class of drug, like, simple analgesics, triptans, and opioids) in a month, used for relief of headache for three or more months, in a known patient of primary headache disorder.
The aim of this study was to review the topic of MOH and present the details of this disorder with an emphasis on recent updates in the field of pathophysiology and treatment.
Literature search was performed in the PubMed/MEDLINE and Cochrane database with appropriate keywords and relevant full-text articles were reviewed for writing this article.
Over the years, the concept of MOH has evolved, although the exact pathophysiology is still being explored. In a susceptible individual interplay of genetics, change in pain pathways, changes in areas of the brain associated with the perception of pain, and changes in the neurotransmitters have been implicated. It has to be differentiated from other secondary chronic daily headache disorders, by a careful history, targeted examination, details of intake of medications. Treatment predominantly involves patient education, removal of the offending agent, and initiation of prophylactic medications for primary headache disorder in the outpatient or inpatient services.
MOH is a secondary headache disorder, which should be considered in any chronic headache patient. There are various pathophysiological mechanisms attributed to its development. Management includes educating the patients about the disorder, detoxification, and prophylactic therapy.
药物过度使用性头痛（MOH）是一种高度致残的头痛疾病，影响全球约 1%的人口。它与头痛发作 15 天或以上有关，在一个月内，使用急性对症药物（取决于药物类别，如简单的镇痛药、曲坦类药物和阿片类药物）10-15 天，用于缓解头痛的药物超过 3 个月，在已知的原发性头痛疾病患者中。
本研究旨在综述 MOH 这一课题，并详细介绍该疾病，重点介绍病理生理学和治疗方面的最新进展。
在 PubMed/MEDLINE 和 Cochrane 数据库中进行文献检索，使用适当的关键词，并对相关的全文文章进行了综述，以撰写本文。
多年来，尽管确切的病理生理学仍在探索中，但 MOH 的概念已经发展。在易感个体中，遗传、疼痛途径的变化、与疼痛感知相关的大脑区域的变化以及神经递质的变化相互作用。它必须与其他继发性慢性每日头痛疾病区分开来，这需要仔细的病史、有针对性的检查、药物摄入的详细信息。治疗主要包括对患者进行教育、去除致病药物以及在门诊或住院服务中开始预防性治疗原发性头痛疾病。
MOH 是一种继发性头痛疾病，应在任何慢性头痛患者中考虑。有各种病理生理学机制归因于其发展。管理包括教育患者了解该疾病、解毒和预防治疗。
