Entwicklung sekundärer Kopfschmerzen durch Exposition oder Übergebrauch einer Substanz

ZUSAMMENFASSUNG

Sekundäre Kopfschmerzen, die auf die Exposition, den Übergebrauch oder den Entzug einer Substanz zurückzuführen sind, sind in Kapitel 8 der 3. Auflage der Internationalen Klassifikation von Kopfschmerzerkrankungen (ICHD-3) aufgeführt. Es werden 3 Unterkapitel unterschieden: 8.1. Kopfschmerz zurückzuführen auf Substanzgebrauch oder Substanzexposition, 8.2. Kopfschmerz zurückzuführen auf einen Medikamentenübergebrauch und 8.3. Kopfschmerz zurückzuführen auf den Entzug einer Substanz. Ersterer – Kopfschmerz zurückzuführen auf Substanzgebrauch oder Substanzexposition – bezieht sich auf einen Kopfschmerz mit Beginn unmittelbar oder innerhalb von Stunden nach der Exposition. Hingegen ist der „Kopfschmerz zurückzuführen auf einen Medikamentenübergebrauch“ (MOH) definiert als ein Kopfschmerz, der an 15 oder mehr Tagen pro Monat bei Patienten mit einer vorbestehenden primären Kopfschmerzerkrankung auftritt und sich als Folge der regelmäßigen Einnahme akuter Kopfschmerzmedikamenten über einen Zeitraum von mehr als 3 aufeinanderfolgende Monate entwickelt hat. Bezüglich letzterem, ist der Entzug von Koffein, Östrogen und Opioiden am häufigsten mit der Entwicklung von Kopfschmerzen assoziiert.

Der vorliegende Artikel soll einen Überblick über die neuesten Erkenntnisse zur Klassifikation, Pathophysiologie und zu Behandlungsstrategien dieser sekundären Kopfschmerzentitäten geben und legt den Schwerpunkt dabei auf die Unterkapitel 8.1 und 8.2. der ICHD-3-Klassifikation.

ABSTRACT

Secondary headaches attributed to exposure, overuse or withdrawal of a substance are listed in chapter eight of the 3 rd edition of the International Classification of Headache Disorders (ICHD-3). Three sub-chapters are distinguished: 8.1 Headache attributed to use of or exposure to a substance, 8.2 Medication-overuse headache (MOH) and 8.3 Headache attributed to substance withdrawal. Headache attributed to substance use or substance exposure refers to a headache that begins immediately or within hours after exposure. Medication-overuse headache (MOH) is defined as a headache that occurs on 15 or more days per month in patients with a pre-existing primary headache disorder and develops as a result of regular use of acute headache medication for more than three consecutive months. Regarding the latter, withdrawal of caffeine, estrogen and opioids is most commonly associated with the development of headache.

This article aims to provide an overview of the latest knowledge on the classification, pathophysiology and treatment strategies for these secondary headache disorders, focusing on subchapters 8.1 and 8.2 of the ICHD-3 classification.

Schlüsselwörter

Kopfschmerz bei Medikamentenübergebrauch - sekundärer Kopfschmerz - Substanz - Exposition - Entzug

Key words

Medication-overuse headache - secondary headache - substance - exposure - withdrawal

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