BIDMC Comprehensive Headache Center, Department of Neurology and Department of Anaesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Nat Rev Dis Primers. 2023 Feb 2;9(1):5. doi: 10.1038/s41572-022-00415-0.
Medication overuse headache (MOH) is a secondary headache disorder attributed to overuse of acute headache medications by a person with an underlying headache disorder, usually migraine or tension-type headache. MOH is common among individuals with 15 or more headache days per month. Although MOH is associated with substantial disability and reductions in quality of life, this condition is often under-recognized. As MOH is both preventable and treatable, it warrants greater attention and awareness. The diagnosis of MOH is based on the history and an unremarkable neurological examination, and is made according to the diagnostic criteria of the International Classification of Headache Disorders third edition (ICHD-3). Pathophysiological mechanisms of MOH include altered descending pain modulation, central sensitization and biobehavioural factors. Treatment of MOH includes the use of headache preventive therapies, but essential to success is eliminating the cause, by reducing the frequency of use of acute headache medication, and perhaps withdrawing the overused medication altogether. Appropriate treatment is usually highly effective, leading to reduced headache burden and acute medication consumption.
药物过度使用性头痛（MOH）是一种继发性头痛障碍，归因于患有潜在头痛障碍（通常为偏头痛或紧张型头痛）的人过度使用急性头痛药物。MOH 在每月头痛 15 天或以上的人群中较为常见。尽管 MOH 与严重的残疾和生活质量下降有关，但这种疾病常常未被识别。由于 MOH 既可以预防也可以治疗，因此值得引起更多关注和认识。MOH 的诊断基于病史和无明显异常的神经系统检查，并根据头痛障碍国际分类第三版（ICHD-3）的诊断标准做出。MOH 的病理生理机制包括下行性疼痛调节改变、中枢敏化和生物行为因素。MOH 的治疗包括使用头痛预防疗法，但成功的关键是消除病因，即减少急性头痛药物的使用频率，甚至可能完全停用过度使用的药物。适当的治疗通常非常有效，可降低头痛负担和急性药物的使用量。
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