Der Schmerz

, Volume 20, Issue 2, pp 160–163 | Cite as

Behandlung eines atypischen und therapierefraktären Clusterkopfschmerzes mit Topiramat

Fallberichte
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Zusammenfassung

Der Clusterkopfschmerz, nach dem Spannungskopfschmerz und der Migräne die dritthäufigste primäre Zephalgie, ist durch Attacken heftigster Schmerzen mit starker Beeinträchtigung des Alltags gekennzeichnet. Nach der Diagnosestellung muss deshalb rasch eine wirksame Therapie erfolgen.

Wir berichten über einen Patienten, der über typische Clusterattacken klagte, zwischen denen aber ein atypischer, kontinuierlicher, weniger intensiver Kopfschmerz persistierte, sodass differenzialdiagnostisch auch eine Hemicrania continua auszuschließen war. Die gängigen Mittel zur Akuttherapie der Clusterattacken erwiesen sich als unwirksam, ebenso eine Prophylaxe mit Kortikosteroiden und Verapamil. Erst die Verabreichung von Topiramat führte umgehend zu einer deutlichen Schmerzlinderung.

Schlüsselwörter

Clusterkopfschmerz Kopfschmerz Therapieresistenz Topiramat 

Remission of atypical and refractory cluster headache after topiramate administration

Abstract

Cluster headache is the third most frequent type of primary cephalgias only exceeded in frequency by tension-type headache and migraine. Cluster headache is characterized by periodic attacks of unilateral excruciating pain and accompanying autonomic features. It is arguably the most disabling form of primary headache. Therefore, prompt recognition of this disorder is necessary to provide an opportunity for effective treatment.

We report on a patient with cluster headache, who complained about an atypical interval of dull headache between the cluster attacks, thus excluding the differential diagnosis of hemicrania continua. The common drugs for acute cluster attacks proved to be ineffective as well as prophylactic treatment with steroids and verapamil. Only administration of topiramate led to relief of pain.

Keywords

Cluster headache Headache Refractory Topiramate 

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Neurologische Klinik des Krankenhauses MerheimKliniken der Stadt Köln
  2. 2.Neurologische Klinik des Krankenhauses MerheimStädtische KlinikenKöln

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