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Neurologie up2date 2023; 06(04): 345-365
DOI: 10.1055/a-2123-7121
Kopfschmerz und andere Schmerzsyndrome

Neues bei Kopfschmerzen 2022–2023

Hans-Christoph Diener
,
Dagny Holle-Lee
,
Charly Gaul
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Die letzte Zusammenfassung zu neuen Aspekten der Epidemiologie, Klinik und Therapie von Kopfschmerzen in der Neurologie up2date erschien vor über 2 Jahren. In der Zwischenzeit gibt es viele neue wissenschaftliche Erkenntnisse zu Kopfschmerzen. Diese Übersicht stützt sich auf eine Literaturrecherche für den Zeitraum von Januar 2022 bis Juli 2023.
Kernaussagen

  • Viele Patienten überschätzen die tatsächliche Bedeutung von Triggerfaktoren für das Auslösen von Migräneattacken.

  • Triptane sind die Medikamente der 1. Wahl zur Behandlung akuter Migräneattacken.

  • Es gibt bisher keine direkten Vergleichsstudien zwischen den Triptanen, den Ditanen und den Gepanten bezüglich der Wirksamkeit bei der Therapie akuter Migräneattacken.

  • In Deutschland werden immer noch zu wenige Migränepatienten mit einem Triptan behandelt.

  • Nach der Einnahme von Lasmiditan darf über einen Zeitraum von 8 h kein Kraftfahrzeug geführt werden.

  • Antikörper gegen PACAP sind möglicherweise zur Prophylaxe der Migräne wirksam.

  • Patienten mit chronischer Migräne und Medikamentenübergebrauch haben den höchsten Nutzen von einer Therapie mit monoklonalen Antikörpern gegen CGRP oder den CGRP-Rezeptor.

  • Die monoklonalen Antikörper gegen CGRP unter den CGRP-Rezeptor weisen eine sehr gute Verträglichkeit auf.

  • Amitriptylin ist die wirksamste Substanz zur Prophylaxe des chronischen Kopfschmerzes vom Spannungstyp.

  • Kopfschmerzen gehören zu den häufigsten Symptomen einer akuten COVID-19-Erkrankung. Im Anschluss kann es in seltenen Fällen zu einem new daily persistent Headache kommen. Dies kann auch nach einer COVID-19-Impfung der Fall sein.

  • Der monoklonale Antikörper Erenumab ist bei der idiopathischen Trigeminusneuralgie nicht wirksam.

  • Eine vielversprechende neue Therapieoption bei der idiopathischen intrakraniellen Hypertension ist möglicherweise der GLP-1-Rezeptor-Agonist Exenatide.

Schlüsselwörter

Schmerztherapie - Migräne - Clusterkopfschmerz - Spannungskopfschmerz - Medikamentenübergebrauch


Publication History

Article published online:
08 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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