Department of Neurology, Medical University of Warsaw, 80 Cegłowska St., 01-809 Warsaw, Poland.
Toxins (Basel). 2022 Sep 5;14(9):619. doi: 10.3390/toxins14090619.
Headaches are a very common condition that most people will experience many times during their lives. This article presents the primary headaches, which are a large group of diseases where the headache is not a symptom of another known disease. Tension-type headache affects approximately 80% of the general population, and the prevalence of migraine is estimated at 10-12%. Clinical data and experience to date have demonstrated that botulinum toxin may be an effective prophylactic treatment for chronic headache types. It has been used in neurology for the treatment of dystonia and blepharospasm. Now it has been approved to treat chronic migraine and has been shown to confer significant benefit in refractory cases. Based on clinical experience botulinum toxin has also been tried in other headache disorders. While it is intuitively attractive to think that due to its effect on pain by sensory modulation, there may also be efficacy in its use in chronic tension-type headache and cluster headache, so far, there is little evidence to support this. Botulinum toxin is effective in pain control through its interaction with the SNARE complex, which inhibits the release of neurotransmitters, such as glutamate, substance P and calcitonin gene-related peptide. OnabotulinumtoxinA is effective not only in headache frequency and pain intensity but in other parameters, including quality of life.
头痛是一种非常常见的病症，大多数人在一生中都会经历多次。本文介绍了原发性头痛，这是一大类疾病，其中头痛不是其他已知疾病的症状。紧张型头痛影响大约 80%的普通人群，偏头痛的患病率估计为 10-12%。迄今为止的临床数据和经验表明，肉毒毒素可能是慢性头痛类型的有效预防治疗方法。它已在神经病学中用于治疗肌张力障碍和眼睑痉挛。现在它已被批准用于治疗慢性偏头痛，并已证明在难治性病例中具有显著益处。基于临床经验，肉毒毒素也已在其他头痛疾病中进行了尝试。虽然由于其对疼痛的感觉调节作用，人们直觉上认为它在慢性紧张型头痛和丛集性头痛的治疗中也可能有效，但到目前为止，几乎没有证据支持这一点。肉毒毒素通过与 SNARE 复合物相互作用来有效控制疼痛，从而抑制神经递质（如谷氨酸、P 物质和降钙素基因相关肽）的释放。OnabotulinumtoxinA 不仅在头痛频率和疼痛强度方面有效，而且在其他参数方面，包括生活质量方面都有效。
