2010 (1)
2011 (1)
2017 (75)
2018 (60)
1。终身发病率:妇女43%,男人18%,儿童4-5%
2。经常是单侧搏动性头痛
3。双侧头痛:成年人:40%, 儿童:60%
4。短暂发作性的头痛:每月少于15天
5。慢性头痛:每月大于15天
6。相关症状:畏光,恐声,惧气味,恶心和呕吐
7。20%的病人有预兆:最多的是视觉症状,少数人有感觉和偏瘫症状
8。有一定的家属史
9。月经期间可能加重。
急性治疗:在24小时内,恢复功能,减轻病痛,减少复发。
A: 家中非特效治疗:
Aspirin (650-1000 mg),
Ibuprofen (400-800 mg),
Naproxen (125-550 mg),
Diclofenac (50 mg),
Ketoprofen (50-75 mg)
Ketorolac (10 mg),
Etodolac (200-500 mg),
Mecofenamate (50-100 mg)
B: 特效治疗-1: Triptans
Almotriptan (Axert, 6.25,12.5 mg, onset 1-2hr, t1/2 3-4hr),
Eletriptan (Relpax, 20, 40 mg, onset <1hr, t1/2 4 hr),
Rizatriptan (Maxalt, 5, 10 mg, onset 30 min, t1/2 2-3hr),
Sumatriptan (Imitrex, 25, 50, 100 mg, onset oral 1-2hr, t1/2-3hr),
Zolmitriptan (Zomig, 2.5, 5 mg, onset <1hr, t1/2 -3hr),
Frovatriptan (Frova, 2.5 mg, onset 2hr, t1/2 26hr),
Naratriptan (Aerge, 1, 2.5 mg, onset 1hr, t1/2 6hr).
C: 特效治疗-2: Ergots
Dihydroergotamine (DHE, 0.5, 1 mg nasal spray or IV injection)
D: 急诊室治疗:
Sumatriptan: 4-6 mg subcutaneously
OR
Headache cocktail:
Valproate 500 mg intra-venously
Dexamethasone 10 mg intra-venously
Magnesium solfate 1-2 gram intra-venously
Metoclopramide 10-20 mg intra-venously
预防性治疗
减少复发频率,严重性,延迟疾病进展,增强对急性治疗的反应性
A: 改变生活方式:
要有足够的睡眠,有氧运动,少量多餐,避免咖啡因,巧克力, 喝酒,和奶酪等发
酵食品。
B: 特效预防性药品:
1. Beta-adrenergic blockers:
Metoprolol 50-150 mg twice a day
Propranolol 80-240 mg daily
Timolol 10-20 mg twice a day
2. Antiepileptic drugs
Topiramate 25-150 mg twice a day
Divaproex 250-1500 mg twice a day
3. Antidepressants
Amitriptyline 25-150 mg bedtime
Venlafaxine 37.5-150 mg daily
C: 非主流的预防性药品和方法:
Magnesium 400 mg 1-2 times a day
Coznzyme Q10 300 mg daily
Riboflavin (Vit B2) 400 mg daily
Butterbur 150 mg daily
Feverfew: 50-100 mg 1-2 times a day
Folic acid 2 mg, Vit B12 400 ug, and Vit B6 25 mg, daily
Acupuncture 45% reduction of headache
Oxygen 10-12 Liter/min for cluster headache