Kopfschmerz vom Spannungstyp

Quo vadis?

Tension type headaches

Quo vadis?

Zusammenfassung

Der episodische Kopfschmerz vom Spannungstyp (eSK) gilt als die häufigste Kopfschmerzform. Tritt der Kopfschmerz vom Spannungstyp an mehr als 15 Tagen im Monat in mindestens 3 aufeinanderfolgenden Monaten auf, spricht man vom chronischen Kopfschmerz vom Spannungstyp (cSK). In den letzten Jahren zeigte sich, dass gerade die Abgrenzung einer eSK-Attacke von einer leichten Migräneattacke und die Abgrenzung eines cSK von einer chronischen Migräne schwierig ist. Im Folgenden sollen Kriterien zur leichteren Abgrenzung sowie die Therapie des Kopfschmerzes vom Spannungstyp diskutiert werden. Im Weiteren werden Befunde vorgestellt, die für oder gegen eine gemeinsame Pathophysiologie (im Sinne der Konvergenzhypothese) von Kopfschmerzen vom Spannungstyp und Migräne sprechen.

Abstract

Episodic tension type headache is considered to be the most prevalent primary headache. If tension type headache occurs on more than 15 days per month for at least 3 consecutive months, it is classified as chronic tension type headache. In recent years, it has become obvious that it is difficult to distinguish between episodic tension type headache and a moderate migraine attack and also between chronic tension type headache and chronic migraine. In the paper, we discuss how the differential diagnosis can be more specific and which therapy is supported by the literature. In addition, we discuss differences and similarities of tension type headache and migraine and a possible similar pathophysiology of both (convergence hypothesis).

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Correspondence to Univ. Prof. Dr. med. Andreas Straube.

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Interessenkonflikt

A. Straube: Persönliche Honorare für Fortbildungsvorträge und Advisory Boards von Allergan, AllergoSan, Bayer, Novartis, Lilly, Teva. Forschungsförderung durch Deutsche Forschungsgemeinschaft (DFG), Bundesministerium für Bildung und Forschung (BMBF), Universität München, Friedrich-Baur Stiftung. S. Förderreuther: Persönliche Honorare für Fortbildungsvorträge und Advisory Boards von Allergan, AstraZeneca, Novartis, Hormosan Pharma, Sanofi. O.E. Eren: Reiseunterstützung von Allergan, Lilly. Forschungsförderung durch Friedrich-Baur-Stiftung, BMBF.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Straube, A., Förderreuther, S. & Eren, O.E. Kopfschmerz vom Spannungstyp. Schmerz 34, 464–475 (2020). https://doi.org/10.1007/s00482-020-00495-5

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Schlüsselwörter

  • Episodischer Kopfschmerz vom Spannungstyp
  • Chronischer Kopfschmerz vom Spannungstyp
  • Migräne
  • Chronischer täglicher Kopfschmerz
  • Absteigendes schmerzhemmendes System

Keywords

  • Tension type headache, episodic
  • Tension type headache, chronic
  • Migraine disorders
  • Chronic daily headache
  • Descending anti-nociceptive pathways