打破循环:解开耐性偏头痛的诊断,病理生理和治疗挑战
1Department of Neurology, Dignity Health, St Joseph's Hospital and Medical Center, Lewis Headache Clinic, Barrow Neurological Institute, Phoenix, AZ, United States.
Frontiers in neurology
|October 13, 2023
概括
耐火性偏头痛是一种慢性和耐治疗的头痛,缺乏明确的诊断标准和确定的治疗方法. 进一步的研究和多学科的护理对于管理这个具有挑战性的患者群体至关重要.
科学领域:
- 神经学 神经学
- 头痛 医学 医学 医学
背景情况:
- 阻断性偏头痛是一种鲜为人知的并发症,其特点是慢性偏头痛抵抗标准治疗.
- 患病率尚不清楚,但在头痛诊所中,药物耐药性很常见,这给治疗带来了重大挑战.
- 有限的文献指南存在,用于管理耐火偏头痛患者.
研究的目的:
- 审查耐性偏头痛的诊断挑战.
- 探索耐火偏头痛的病理生理基础.
- 概述耐性偏头痛的管理策略.
主要方法:
- 审查现有的关于耐火偏头痛的文献.
- 对拟议的诊断标准进行分析.
- 讨论当前的治疗方法,包括n-of-1试验和非药物管理.
主要成果:
- 对于耐火性偏头痛没有普遍接受的诊断标准.
- 建议的标准往往缺乏具体性,可能不适用于不同的人群.
- 病理生理学被假设为持久的"开启"状态与中央敏感,但异质性是可能的.
- 治疗依赖于经验的n-of-1试验和指南失败后的非药理方法.
结论:
- 耐火性偏头痛带来了重大的诊断和治疗挑战.
- 了解它的病理生理学需要进一步的研究.
- 多学科的护理模式和未来的研究对于改善患者的治疗结果至关重要.
相关概念视频
Psychosis: Goals of Pharmacotherapy
146
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
146
Analgesia and Pain Management
636
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
636
Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10


