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Chronische Migräne

Chronic migraine

Zusammenfassung

Die Klassifikation der Internationalen Kopfschmerzgesellschaft (IHS) unterteilt Kopfschmerzen in episodische und chronische Formen. Die chronische Migräne ist definiert als Kopfschmerzen an mehr als 15 Tagen im Monat für einen Zeitraum von mehr als 3 Monaten, wobei der Kopfschmerz an 8 oder mehr Tagen die Kriterien für eine Migräne erfüllen muss oder erfolgreich mit Triptanen oder Ergotaminpräparaten behandelbar war. Die Prävalenz der chronischen Migräne liegt zwischen 2 und 4 %. Die chronische Migräne schränkt die Lebensqualität massiv ein und es bestehen erheblich mehr Komorbiditäten als bei der episodischen Migräne. Es gibt nur wenig prospektive randomisierte Studien zur Behandlung der chronischen Migräne, da die meisten Patienten mit chronischer Migräne aus früheren Therapiestudien ausgeschlossen wurden. Wissenschaftlich belegt sind die Wirkungen von Topiramat und Botulinum-Toxin als Prophylaktika.

Summary

The classification of the International Headache Society (IHS) generally differentiates episodic from chronic headache. Chronic migraine is defined as headache on 15 and more days a month over more than 3 months and headache on 8 days or more fulfils the criteria for migraine or were triptan/ergot-responsive when thought to be migrainous in early stages of the attack. The prevalence of chronic migraine is estimated at 2-4 %. The quality of life is highly compromised in this condition and comorbidities are much more frequent compared to episodic migraine. Data from prospective randomized studies are scarce as most patients with chronic migraine were excluded from previous trials and only few studies were conducted for this condition. The efficacy for prophylactic treatment compared with placebo is proven for topiramate and onabotulinum toxin A.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H.C. Diener erhielt Honorare für die Planung, Ausführung oder Teilnahme an klinischen Studien, Teilnahme an Advisory Boards oder Vorträge von: Addex Pharma, Allergan, Almirall, AstraZeneca, Bayer Vital, Berlin Chemie, Boehringer Ingelheim, Bristol Myers Sqibb, Colucid, Coherex, GlaxoSmithKline, Grünenthal, Janssen-Cilag, Lilly, La Roche, 3M Media, Menerini, Minster, MSD, Neuroscore, Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Schaper an Brümmer, Sanofi, St. Jude Medical und Weber & Weber. Finanzielle Unterstützung für Forschungsprojekte wurde gewährt von: Allergan, Almirall, AstraZeneca, Bayer, GSK, Janssen-Cilag, MSD und Pfizer. Kopfschmerzforschung an der Universitätsklinik für Neurologie und dem Westdeutschen Kopfschmerzzentrum Essen erfolgte durch: Deutsche Forschungsgemeinschaft (DFG), Bundesministerium für Bildung und Forschung (BMBF) und die Europäische Unio (EU). HCD besitzt keine Aktien oder Anteile von Pharmafirmen. D. Holle erhielt finanzielle Unterstützung für Forschungsprojekte von Allergan sowie eine Wissenschaftliches Stipendium von der Fa. Grünenthal. D. Müller: keine Interessenkonflikte. S. Nägel: keine Interessenkonflikte. K. Rabe erhielt Honorare für Vorträge von der Fa. Allergan. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Diener, H., Holle, D., Müller, D. et al. Chronische Migräne. Nervenarzt 84, 1460–1466 (2013). https://doi.org/10.1007/s00115-012-3625-3

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  • DOI: https://doi.org/10.1007/s00115-012-3625-3

Schlüsselwörter

  • Chronische Migräne
  • Pathophysiologie
  • Therapie
  • Topiramat
  • Botulinum-Toxin

Keywords

  • Chronic migraine
  • Pathophysiology
  • Therapy
  • Topiramate
  • Botulinum toxin