Focus on therapy: hemicrania continua and new daily persistent headache

The Journal of Headache and Pain

Tutorial

Enrico Ferrante¹  Carlo Lisotto²  Paolo Rossi³  Cristina Tassorelli⁴  Marta Allena⁴  Giuseppe Nappi⁵ 

[1] Department of Neuroscience, Niguarda Ca’ Granda Hospital, Milan, Italy;Headache Centre, Department of Neuroscience, S. Vito al Tagliamento Hospital, San Vito al Tagliamento (PN), Italy;Headache Clinic INI Grottaferrata, Rome, Italy;Headache Science Centre, IRCCS “Neurological Institute C. Mondino” Foundation, University Centre for Headache and Adaptive Disorders (UCADH), University of Pavia, Pavia, Italy;Headache Science Centre, IRCCS “Neurological Institute C. Mondino” Foundation, University Centre for Headache and Adaptive Disorders (UCADH), University of Pavia, Pavia, Italy;Chair of Neurology, University “La Sapienza”, Rome, Italy;

关键词: Hemicrania continua;    New daily persistent headache;    Chronic daily headache;    Therapy;    Management;   

DOI  :  10.1007/s10194-010-0194-3

 received in 2009-12-03, accepted in 2010-01-25,  发布年份 2010

来源: Springer

【 摘 要 】

Hemicrania continua (HC) and new daily-persistent headache (NDPH) represent the only two forms of chronic daily headache in Chap. IV “Other Primary Headaches” of the second edition of the International Classification of Headache Disorders. HC and NDPH are rare and poorly defined from a pathophysiological point of view; as a consequence, their management is largely empirical. Indeed, there is a lack of prospective, controlled trials in this field, and treatment effectiveness is basically inferred from the results of sparse open-label trials, retrospective case series, clinical experience and expert opinions. In this narrative review we have summarised the information collected from an extensive analysis of the literature on the treatment of HC and NDPH in order to provide the best available and up-to-date evidence for the management of these two rare forms of primary headache. Indomethacin is the mainstay of HC management. The reported effective dose of indomethacin ranges from 50 to 300 mg/day. Gabapentin 600–3,600 mg tid, topiramate 100 mg bid, and celecoxib 200–400 mg represent the most interesting alternative choices in the patients who do not tolerate indomethacin or who have contraindications to its use. NDPH is very difficult to treat and it responds poorly only to first-line options used for migraine or tension-type headache.

【 授权许可】

Unknown   
© Springer-Verlag 2010