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Life-course-Betrachtung der häufigsten Kopfschmerzformen

Spontanverlauf, Remission und Persistenz

A view on the life course of the most prevalent headache disorders

Spontaneous course, remission, and persistence

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Primäre Kopfschmerzerkrankungen können sich hinsichtlich ihrer klinischen Symptome über die Lebensspanne eines Menschen verändern und in ihrer Ausprägung und Frequenz deutlich fluktuieren. Vor der Pubertät sind Jungen und Mädchen gleich häufig betroffen. Nach der Pubertät sind es in aller Regel vor allem die Frauen. Die Behandlung primärer Kopfschmerzerkrankungen erfolgt stets unter Berücksichtigung der Schwere und Häufigkeit der Kopfschmerzattacken sowie begleitender Komorbiditäten. Mittels vorbeugender Maßnahmen können Kopfschmerzverläufe moduliert werden. Eine gezielte Prophylaxe ist der wichtigste Ansatz, um eine Schmerzchronifizierung durch Übergebrauch von Medikamenten zu verhindern. Während sich primäre Kopfschmerzerkrankungen im höheren Lebensalter meist abschwächen, nehmen die sekundären Kopfschmerzerkrankungen mit dem Alter eher zu. Sie sind oft Ausdruck einer onkologischen oder vaskulären Erkrankung oder Nebenwirkung von Medikamenten. Ihre Behandlung und Prognose richtet sich stets nach der zugrunde liegenden Erkrankung.

Abstract

Symptoms and signs of primary headache disorders can change during one’s lifetime. Moreover, the impact and the frequency of attacks can fluctuate in an individual patient over time. Before puberty, boys and girls are equally affected; after puberty most headache disorders predominate in women. The treatment of primary headache disorders always has to take into consideration the severity and the frequency of headache attacks as well as the relevant comorbidities. Prophylactic headache treatment can modulate the course of primary headache disorders. Specific prophylactic treatment is the most important instrument for avoiding headache chronification caused by medication overuse. While primary headache disorders tend to improve in elderly patients, secondary headache disorders peak in elderly people. They are often a symptom of oncologic diseases, vascular disorders, or are linked to side effects of drugs that are prescribed more frequently in the elderly. The treatment and the prognosis of secondary headache disorders always depend on the underlying disease.

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S. Förderreuther gibt an, dass kein Interessenkonflikt besteht.

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  1. Neurologische Klinik und Poliklinik, Universität München, Neurologischer Konsiliardienst am Standort Innenstadt Ziemssenstraße 1, 80336, München, Deutschland

    S. Förderreuther

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Förderreuther, S. Life-course-Betrachtung der häufigsten Kopfschmerzformen. Bundesgesundheitsbl. 57, 935–939 (2014). https://doi.org/10.1007/s00103-014-1995-3

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