Kopf- und Gesichtsschmerzen im Alter

A. Straube; B. Hinz; P. Kropp; S. Förderreuther; C. Lampl; P. Sandor; A. May; G. Haag

doi:10.1055/s-0038-1628187

Nervenheilkunde, Table of Contents

Nervenheilkunde 2012; 31(10): 733-757
DOI: 10.1055/s-0038-1628187

Expertenempfehlung

Schattauer GmbH

Kopf- und Gesichtsschmerzen im Alter

Epidemiologie, Klinik und Therapie Expertenempfehlungen der Deutschen Migräne- und Kopfschmerzgesellschaft in Zusammenarbeit mit der Österreichischen Kopfschmerzgesellschaft und der Schweizerischen KopfwehgesellschaftHeadache and facial pain in the elderlyEpidemiology, clinic and therapy

Authors

A. Straube

¹Neurologische Klinik der Universität München
B. Hinz

²Institut für Toxikologie und Pharmakologie, Universität Rostock
P. Kropp

³Institut für Medizinische Psychologie und Medizinische Soziologie, Universität Rostock
S. Förderreuther

¹Neurologische Klinik der Universität München
C. Lampl

⁴Neurologie der Barmherzigen Brüder, Linz, Österreich
P. Sandor

⁵Kantonsspital Baden, Baden, Schweiz
A. May

⁶Institut für systemische Neuroforschung, Uniklinik Hamburg Eppendorf
G. Haag

⁷Michael Balint Klinik, Königsfeld

Abstract

Zusammenfassung

Die sozio-demografische Entwicklung bedingt, dass sich immer häufiger ältere und alte Menschen mit Kopfschmerzen klinisch vorstellen. Diese Leitlinie soll ein erster Versuch sein, die Literatur zu Kopfschmerzen und Gesichtsschmerzen bei dieser Patientengruppe zusammenzufassen und spezifische Therapie-Empfehlungen zu geben. Dabei zeigt sich, dass die Alters-gruppe der über 65-Jährigen in fast allen Therapiestudien nicht berücksichtigt wird und die übrigen Studien meist diese Altersgruppe nicht betrachten. Wenig untersucht ist der Wandel der Symptome bei primären Kopfschmerzen in Abhängigkeit vom Alter. Generell treten bei Migräne vegetative Symptome seltener auf und Kopfschmerzen werden häufiger als drückend beschrieben. Der idiopathische schlafgebundene Kopfschmerz, die Arteriitis cranialis, die post-zosterische Neuralgie und die klassische Trigeminusneuralgie sind Erkrankungen, die ausschließlich bzw. vorwiegend im höheren Alter auftreten. Therapiestudien mit älteren Patienten sind nicht publiziert, generell gilt die Emp-fehlung, Leber- und Nierenfunktion zu beach-ten, niedrig dosiert zu beginnen und die Dosis langsam bis zur Wirksamkeit zu steigern.

Summary

The part of elderly people is strongly increasing in all western countries. This is the reason for that more elderly patients with headaches are seen in the health system. The present guideline tries to screen the available literature about headaches in the elderly and to develop therapeutic recommendations. Generally there is only a small number of paper which deal with this specific topic and there are nearly no studies about the headache therapy in patients older than 65 years. There is some evidence that the symptoms of primary headaches change with age and that the vegetative symptoms decrease and the headaches become more prominent. There are also some headache and facial pain syndromes which mostly develop in patients older than 50 years, e.g. hypnic headache, giant arthritis, zoster neuralgia and trigeminal neuralgia.

Schlüsselwörter

Älterer und alter Patient - primäre Kopfschmerzen - Symptomänderung - sekundäre Kopfschmerzen - Gesichtsschmerzen - Neuralgien - Häufigkeit - Therapie

Keywords

Elderly patient - primary headaches - symptomatolgy - secondary headaches - facial neuralgia - epidemiology - therapy

Full Text

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