Wessely P, Wöber-Bingöl C
Universitätsklinik für Neurologie, Wien.
Wien Med Wochenschr. 1993;143(19-20):514-8.
The clinical use of calcium antagonists (Ca-antagonists) in neurological diseases focuses on 2 main therapeutic fields: (a) For the therapy of migraine flunarizine is the first choice therapy and nimodipine is a second line treatment. With verapamil cluster headache can be treated successfully, flunarizine shows less impressive clinical efficacy. The therapy with flunarizine may be restricted due to the incidence of extrapyramidal disturbances and depressions as known side effects. (b) The therapy of clinical conditions after subarachnoidal bleeding with nimodipine is well established. In the therapy of acute cerebral ischemia the therapeutic efficacy of nimodipine administered orally is not therapeutically proved until now; the intravenous administration of nimodipine offers the risk of acute hypotensive reactions. At present the usefulness of the administration of ca-antagonists in the so-called cerebrovascular insufficiency or dementia and various others cerebral disorders with vertigo could not be demonstrated.
钙拮抗剂（Ca拮抗剂）在神经疾病中的临床应用主要集中在两个主要治疗领域：（a）在偏头痛治疗中，氟桂利嗪是首选治疗药物，尼莫地平是二线治疗药物。维拉帕米可成功治疗丛集性头痛，而氟桂利嗪的临床疗效则不太显著。由于锥体外系障碍和抑郁等已知副作用的发生率，氟桂利嗪的治疗可能会受到限制。（b）尼莫地平用于蛛网膜下腔出血后临床状况的治疗已得到充分确立。在急性脑缺血治疗中，口服尼莫地平的治疗效果迄今尚未得到证实；静脉注射尼莫地平存在急性低血压反应的风险。目前，尚未证实Ca拮抗剂在所谓的脑血管功能不全或痴呆以及其他各种伴有眩晕的脑部疾病中的应用价值。
