[Calcium channel blockers in therapy of neurologic diseases]

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.