Therapie seltener idiopathischer Kopfschmerzerkrankungen

 

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Zusammenfassung

Die Kopfschmerzklassifikation der International Headache Society unterscheidet in ihrem Kapitel 4 verschiedene idiopathische Kopfschmerzerkrankungen, die als selten gelten, aber als eigenständige Entitäten aufgefasst werden müssen. Zu diesen gehören der primäre stechende Kopfschmerz, der primäre Hustenkopfschmerz, der primäre Kopfschmerz bei körperlicher Anstrengung, der primäre Kopfschmerz bei sexueller Aktivität, der primäre schlafgebundene Kopfschmerz, der primäre Donnerschlagkopfschmerz, die Hemicrania continua und der neu aufgetretene tägliche Kopfschmerz. Es handelt sich um harmlose Erkrankungen mit einer guten Prognose, die aber die Lebensqualität der Betroffenen erheblich einschränken können. Aufgrund einer Analyse der publizierten Fallberichte und einem Expertenkonsens werden für diese Kopfschmerzerkrankungen Therapieempfehlungen gegeben, auch wenn große randomisierte, kontrollierte Studien nicht vorliegen. Die meisten dieser Erkrankungen sprechen neben einer spezifischen Therapie unter anderem auf Indometacin an.

Summary

The chapter 4 of the classification of the International Headache Society describes different idiopathic headache disorders which are regarded as an entity although they are very rare. The following headache disorders are classified: primary stabbing headache, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, hemicrania continua, new daily-persistent headache. These disorders are harmless in nature with a good prognosis but can sometimes affect the quality of life in a relevant manner. Based on an analysis of the published case reports and on an expert consent, recommendations for the treatment of these headache disorders are presented although no big randomised, controlled trials are available. Most of these headache disorders respond to indomethacin beside their specific therapy.

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