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群発頭痛、群発期の非発作時治療方針

群発頭痛は激しい頭痛が頻回に起こることより、群発期は頭痛発作が起こらないようにする予防療法を行いながら、頭痛発作が起こってしまったら速やかに軽減・消失させる急性期療法を行う。予防療法の第1選択はベラパミルで、群発期が終了するまで服用する。なお、群発期が終了したか判断が困難なときは発作消失後2週間経過したら中止してみる。
出典
img
1: 著者提供

群発頭痛発作時の様子

左眼に結膜充血、流涙、縮瞳、眼瞼下垂を認める。
出典
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1: Diagnosis and treatment of headache in the ambulatory care setting: a review of classic presentations and new considerations in diagnosis and management.
著者: Natalie Hale, Douglas S Paauw
雑誌名: Med Clin North Am. 2014 May;98(3):505-27. doi: 10.1016/j.mcna.2014.01.006. Epub 2014 Mar 21.
Abstract/Text: Headaches represent the most common constellation of neurologic disorders and are a very common cause of morbidity, lost work time, and decreased quality of life among sufferers. In this article, the diagnostic features, workup, and treatment of common, nuanced, and difficult-to-diagnose headache conditions were addressed. The future will hold a number of changes, with respect to both the diagnosis and treatment of headache disorders. As the aging population continues to grow, primary care providers will need to become increasingly familiar with differentiating between benign primary and more serious secondary headache disorders and will need to be able to treat the headache disorders unique to the elderly. With respect to therapeutic options, the future for treatment of the various headache disorders is promising. With the rise in popularity of complementary medical practices, there is likely to be more research on the roles of acupuncture, herbal and alternative remedies, massage therapy, and mind-body techniques. Further, new research is suggesting that neurostimulation may be useful in certain chronic, intractable headache conditions. Finally, the pathophysiology of headache disorders is still poorly understood and there is great hope that better understanding of the underlying mechanics of headache might contribute to improved treatment modalities and better quality of life for patients.

Copyright © 2014 Elsevier Inc. All rights reserved.
Med Clin North Am. 2014 May;98(3):505-27. doi: 10.1016/j.mcna.2014.01....

群発頭痛急性期の治療方針

群発頭痛は短時間持続の激痛発作を特徴とすることにより発作治療には即効性があり有効率が高いスマトリプタンキット皮下注(3mg)または高濃度酸素吸入を用いる。
出典
img
1: 著者提供

群発頭痛、群発期の非発作時治療方針

群発頭痛は激しい頭痛が頻回に起こることより、群発期は頭痛発作が起こらないようにする予防療法を行いながら、頭痛発作が起こってしまったら速やかに軽減・消失させる急性期療法を行う。予防療法の第1選択はベラパミルで、群発期が終了するまで服用する。なお、群発期が終了したか判断が困難なときは発作消失後2週間経過したら中止してみる。
出典
img
1: 著者提供

群発頭痛発作時の様子

左眼に結膜充血、流涙、縮瞳、眼瞼下垂を認める。
出典
imgimg
1: Diagnosis and treatment of headache in the ambulatory care setting: a review of classic presentations and new considerations in diagnosis and management.
著者: Natalie Hale, Douglas S Paauw
雑誌名: Med Clin North Am. 2014 May;98(3):505-27. doi: 10.1016/j.mcna.2014.01.006. Epub 2014 Mar 21.
Abstract/Text: Headaches represent the most common constellation of neurologic disorders and are a very common cause of morbidity, lost work time, and decreased quality of life among sufferers. In this article, the diagnostic features, workup, and treatment of common, nuanced, and difficult-to-diagnose headache conditions were addressed. The future will hold a number of changes, with respect to both the diagnosis and treatment of headache disorders. As the aging population continues to grow, primary care providers will need to become increasingly familiar with differentiating between benign primary and more serious secondary headache disorders and will need to be able to treat the headache disorders unique to the elderly. With respect to therapeutic options, the future for treatment of the various headache disorders is promising. With the rise in popularity of complementary medical practices, there is likely to be more research on the roles of acupuncture, herbal and alternative remedies, massage therapy, and mind-body techniques. Further, new research is suggesting that neurostimulation may be useful in certain chronic, intractable headache conditions. Finally, the pathophysiology of headache disorders is still poorly understood and there is great hope that better understanding of the underlying mechanics of headache might contribute to improved treatment modalities and better quality of life for patients.

Copyright © 2014 Elsevier Inc. All rights reserved.
Med Clin North Am. 2014 May;98(3):505-27. doi: 10.1016/j.mcna.2014.01....