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Laryngorhinootologie 2019; 98(03): 192-217
DOI: 10.1055/a-0823-4814
CME-Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Kopfschmerzen – Update 2018

Headache – an Update 2018
Hans-Christoph Diener
,
Charly Gaul
,
Dagny Holle-Lee
,
Tim P. Jürgens
,
Torsten Kraya
,
Tobias Kurth
,
Steffen Nägel
,
Lars Neeb
,
Andreas Straube
Further Information

Publication History

Publication Date:
07 March 2019 (online)

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Zusammenfassung

Die Kopfschmerzforschung macht Fortschritte. Dies zeigt sich an der großen Zahl von Publikationen zur Epidemiologie, Pathophysiologie, Akuttherapie und Prophylaxe von Kopfschmerzen. Die vorliegende Übersicht referiert die wichtigsten Studien zu Kopfschmerzen aus dem Zeitraum 2017 bis Juni 2018. Die Auswahl der referierten Studien ist subjektiv und erfolgte nach der Einschätzung der Autoren.

Abstract

Epidemiological studies have shown a clear correlation between migraine and vascular disease in more and more patients. Pathophysiological studies show the relevance of the hypothalamus in the generation of migraine attacks. Glutamate seems to play an important role here. New contrast-enhanced MRI studies support the assumption that the blood-brain barrier remains intact during migraine attacks. The selection of a triptan still remains unique. Neurostimulation has also been included in the acute treatment of migraine. Monoclonal humanized antibodies against CGRP (calcitonin gene-related peptides) and a fully human antibody against the CGRP receptor are effective in the prophylaxis of both episodic and chronic migraine. Tricyclic antidepressants showed efficacy in tension-type headache and is superior compared to SSRIs (selective serotonin reuptake inhibitors). Electronic diaries can reduce the risk of relapse after a medication break in the event of overuse of headache medication. In patients with episodic cluster headache, successful transient therapy with transcutaneous stimulation of the vagus nerve may be required. In trigeminal neuralgia, a significant comorbidity with depression and anxiety disorders was found.

Key words

tension type headache - cluster headache - migraine - pain therapy - trigeminal neuralgia
 

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