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
