Neues zu Kopfschmerzen 2015 – ein Update

Zusammenfassung

Die neuesten und relevanten Informationen über Kopf- und Gesichtsschmerzen werden hier kurz und übersichtlich dargestellt. Eine Studie aus den USA konnte den Wert einer guten Anamnese und eines einfühlsamen, informativen Patientengespräches noch einmal unterstreichen. Gerade in der Schmerztherapie spielt eine gute und fundierte Aufklärung der Patienten über die geplante Therapie eine herausragende Rolle. Neue medikamentöse Therapieoptionen zur Behandlung der Migräne mit monoklonalen Antikörpern gegen den calcitonin-gene related peptide (CGRP) Rezeptor oder CGRP selbst haben die Phase-2-Studien erfolgreich beendet und machen nun einen weiteren Schritt in Richtung Patientenversorgung. Ein weiteres neues Medikament zur Behandlung der Trigeminusneuralgie hat die Phase-2-Studie erfolgreich beendet. Unterschiedliche Verfahren der Neuromodulation sind ebenfalls weiter „en vogue“ und werden in klinischen Studien, evidenzbasiert getestet. Hier ist die transkutane Stimulation des Nervus vagus besonders hervor zu heben, die sich in den folgenden Phase-3-Studien als einfach zu handhabende und wirksame Therapie erweisen könnte. Neben der Therapie werden auch neue pathophysiologische und klinisch-differenzialdiagnostische Erkenntnisse bei unterschiedlichen Kopfschmerzerkrankungen vorgestellt.

Abstract

A systematic review of the latest and most relevant information on different disorders of head and facial pain is presented. A study from the United States has highlighted the value of good history taking and a sensitive and informative patient dialogue. Especially in pain therapy, thorough patient education about the planned treatment approach plays a prominent role. New drug therapies for the treatment of migraine with monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor or the CGRP itself showed promising results in the successfully completed phase-II-studies and represent a further step in patient care. A new drug for the treatment of trigeminal neuralgia has also successfully completed phase-II-trial. Different methods of neuromodulation remain “en vogue” and will be tested in evidence-based, clinical trials. Transcutaneous stimulation of the vagus nerve (tVNS) demonstrated its efficacy in cluster headache and migraine in early phase-II-studies and could prove to be an easy-to-use and effective therapy in phase-III-clinical trials. In addition to therapy options, new pathophysiological and differential diagnostic findings in different primary headache disorders are presented.

Schlüsselwörter

Kopfschmerzen - Migräne - Spannungskopfschmerz - Medikamentenübergebrauchskopfschmerz - Trigeminusneuralgie

Keywords

headache - migraine - tension-type headache - medication overuse headache - trigeminal neuralgia

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