头痛的诊断和治疗:一篇综述
1Department of Neurology, Weill Cornell Medical College, New York, New York.
JAMA
|May 11, 2021
概括
头痛是很常见的疾病,影响90%的人. 偏头痛是最残疾的主要头痛疾病,有各种急性治疗选择.
科学领域:
- 神经学
- 内部医学
背景情况:
- 头痛疾病非常普遍,影响大约90%的人口.
- 偏头痛是导致全球残疾的主要原因,
研究的目的:
- 审查一级和二级头痛疾病的分类和治疗.
- 讨论当前偏头痛的急性和预防性治疗策略.
主要方法:
- 主要头痛疾病 (偏头痛,紧张型,三胞胎自主头痛) 和次要头痛疾病的分类.
- 对表现为头痛的紧急疾病的诊断标准的评估.
- 对包括止痛药,药,药和拉斯米迪坦在内的急性治疗进行审查.
- 预防性治疗的概述,如抗高血压药,抗药,抗抑郁药,CGRP抑制剂和甲基毒素A.
主要成果:
- 压力性头痛影响38%的人口,而偏头痛影响12%的人口,
- 像三药这样的急性治疗可以缓解20%至30%的患者的疼痛,
- 新的药物如和拉斯米迪坦提供了具有不同安全性配置的替代性急性治疗方法.
- 预防性治疗可以减少每月1至3天的偏头痛频率.
结论:
- 头痛是一种严重的公共卫生问题,而偏头痛尤其令人衰弱.
- 有一系列急性和预防性治疗方法可以治疗偏头痛.
- 适当的评估对于区分初级和次级头痛以及识别紧急情况至关重要.
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