頭痛 の 診断 と 治療 ― 概要
1Department of Neurology, Weill Cornell Medical College, New York, New York.
JAMA
|May 11, 2021
まとめ
頭痛障害は一般的であり,人の90%に影響します. 片頭痛は最も障害を伴う主発的な頭痛であり,様々な急性治療法があります.
科学分野:
- 神経学
- 内科 医学
背景:
- 頭痛障害は非常に一般的で,人口の約90%に影響します.
- 片頭痛は 世界中で障害の原因の一つで 生活の質に大きな影響を与えています
研究 の 目的:
- 一次性および二次性頭痛障害の分類と管理を見直す.
- 片頭痛の現在の急性および予防的な治療戦略について議論します.
主な方法:
- 主要な頭痛障害 (片頭痛,緊張型,トライジェミナル自律性頭痛) と二次的な頭痛障害の分類
- 頭痛のような緊急の病気の診断基準の評価
- 鎮痛剤,トリプトン,ゲパン,ラスミディタンを含む急性治療のレビュー.
- 抗高血圧薬,抗薬,抗うつ薬,CGRP阻害剤,オナボトリン毒素Aなどの予防療法についての概要
主要な成果:
- 緊張型頭痛は人口の38%に 影響を及ぼし 片頭痛は12%に 影響を及ぼし 障害を招きます
- トリプトンのような急性治療は 患者の20~30%で痛みを和らげますが 潜在的に有害な効果があります
- ゲパンツやラスミディタンのような新しい薬は,異なる安全性プロファイルを持つ代替急性治療を提供します.
- 予防的な治療は,片頭痛の頻度を1~3日程度減らすことができます.
結論:
- 頭痛は公衆衛生上の重大な問題であり,特に頭痛は衰弱を招きます.
- 片頭痛の管理には様々な急性および予防的な治療法があります
- 主要な頭痛と次要な頭痛を区別し,緊急状態を特定するには適切な評価が不可欠です.
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