Neurol. praxi. 2018;19(3):193-198 | DOI: 10.36290/neu.2018.050

Primary headaches – treatment today and tomorrow

MUDr. Jolana Marková, MUDr. Rudolf Kotas, Ph.D.
Neurologické oddělení Thomayerovy nemocnice, Praha
Neurologická klinika LF UK a FN, Plzeň

This systematic review summarizes the clinical manifestations and the existing knowledge about the treatment of the most frequentprimary headaches – migraine, tension type headache and cluster headache. The acute treatment of migraine attacks consists inthe use of simple analgesics, non-steroidal anti-inflammatory drugs, ergotamines and triptans. Patients with frequent or long lastingattacks require the prophylactic treatment. So far beta-blockers, antiepileptic drugs, calcium channel blockers and antidepressantsare used. Injections of onabotulinumtoxin A reduce the frequency of attacks in chronic migraine. The most promising new approachin the prophylactic treatment are monoclonal antibodies able to block either CGRP or its receptor, such as erenumab, fremanezumab,galcanezumab, and eptinezumab. Tension type headache is the most frequent type of headache. The treatment of acute attacks andprophylactic treatment in frequent episodic and chronic forms are described. Cluster headache (CH) is a primary headache from theTACs group. The clinical manifestation and the existing knowledge about the acute, bridging and prophylactic treatment are described.

Keywords: migraine, trigeminovascular system, calcitonin gene-related peptide (CGRP), monoclonal antibodies against CGRP or
its receptor, tension-type headache, cluster headache, acute, bridging and prophylactis treatment of cluster headache

Received: July 25, 2018; Accepted: August 14, 2018; Published: July 1, 2018  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Marková J, Kotas R. Primary headaches – treatment today and tomorrow. Neurol. praxi. 2018;19(3):193-198. doi: 10.36290/neu.2018.050.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Afridi SK, Shields KG, Bhola R, Goadsby PJ. Greater occipital nerve injection in primary headache syndromes: prolonged effects from a single injection. Pain 2006; 122: 126-129. Go to original source... Go to PubMed...
    2. Ashina M, Tepper S, Brandes JL, Reuter U, Boudreau G, Dolezil D, Cheng S, Leonardi D, Lenz R, Klatt J, Mikol D. Efficacy of Erenumab (a fully human Mab targeting the CGRP receptor) in chronic migraine patients with prior treatment failure: a subgroup analysis of the phase 2, randomized, Double-blind, placebo-controlled study. Cephalalgia 2017; 37(Suppl. 1): 326-327.
    3. Aycardi E, Bigal M, Yeung P, Blankenbiller T, Grozinski-Wolff M, Yang R, Ma Y, Silberstein S, Goadsby PJ and Dodick D. Efficacy and safety of 2 dose regimens of subcutaneous administration of Fremanezumab (TEV-48125) versus placebo for the preventive treatment of episodic migraine. Cephalalgia 2017; 37(Suppl. 1): 343.
    4. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G and Schoenen J. EFNS Guideline on the treatment of tension-type headache. Report of an EFNS task force. European Journal of Neurology 2010; 17(11): 1318-1325. Go to original source... Go to PubMed...
    5. Bendtsen L, Jensen R. Treating tension-type headache - an expert opinion. Expert Opin Pharmacother 2011; 12(7): 1099-1109. Go to original source... Go to PubMed...
    6. Brandes J, Diener H/Ch, Dolezil D, Freeman MC, Mcallister J, Winner P, Cheng S, Leonardi D, Lenz RA, Nikol DD. Chronic migraine treatment with Erenumab: Responder Rates. Cephalalgia 2017; 37(Suppl. 1): 36. Go to PubMed...
    7. Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache. JAMA 2009; 302: 2451-2457. Go to original source... Go to PubMed...
    8. Deen M, Correnti E, Kamm K, Keldermam T, Papetti L, Rubio-Beltran E, Vigneri S, Edvinsson L, Maassen Van Den Brink A and On behalf of the European Headache Federation School of Advanced Studies. Blocking CGRP in migraine patients - a review of pros and cons. The Journal of Headache and Pain 2017; 18(1)96: 1-9. Go to original source... Go to PubMed...
    9. Detke HC, Wang Sh, Skljarevski V, Ahl J, Millen BA, Aurora SK, Yang DY. A Phase 3 Placebo-controlled Study of Galcanezumab in patients with chronic migraine. results from the 3-month double-blind treatment phase of the REGAIN study. Cephalalgia 2017; 37(Suppl. 1): 338.
    10. Diener HCh, Charles A, Goadsby PJ, Holle D. New therapeutic approaches for the prevention and treatment of migraine. Lancet Neurol 2015; 14(10): 1010-1022. Go to original source... Go to PubMed...
    11. Dodick DW, Rozen TD, Goadsby PV, Silberstein SD. Cluster headache. Cephalalgia 2000; 9: 787-803. Go to original source... Go to PubMed...
    12. Dodick DW, Turkel CC, De Gryse RE, Aurora SK, Silberstein SD, Lipton RB, et al. PREEMT Chronic Migraine Study Group. Onabotulinumtoxin A for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMT clinical program. Headache, 2010; 50(6): 921-936. Go to original source... Go to PubMed...
    13. Ekbom K, Svensson DA, Traff H, Waldenlin E. Age at onset and sex ratio in cluster headache: observations over three decades. Cephalalgia 2002; 22(2): 94-100. Go to original source... Go to PubMed...
    14. Ford RG, Ford KT, Swaid S, Young P, Jenelle R. Gamma knife treatment of refractory cluster headache. Headache 1998; 38: 1-9. Go to original source... Go to PubMed...
    15. Freitag FG, Diamond S, Diamond ML, Urban GJ. Divalproex sodium in the preventive treatment of cluster headache. Headache 2000; 40: 408.
    16. Goadsby PJ, Smith J, Dodick D, Lipton R, Silberstein S, Cady R, Hirman J. Migraine prevention benefits of ALD 403 (eptinezumab) begin in the first 24 hours following intravenous administration. Cephalalgia 2017; 37(Suppl. 1): 38-39.
    17. Headache Classification Committee of The International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33(9): 629-808. Go to original source... Go to PubMed...
    18. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38(1): 1-211. Go to original source...
    19. Johnston MM, Rapoport AM. Triptans for management of migraine. Drugs 2010; 70(12): 1505-1518. Go to original source... Go to PubMed...
    20. Khan S, Olesen A, Ashin M. CGRP, a target for preventive therapy in migraine and cluster headache: systematic review of clinical data. Cephalalgia 2017; 0(0): 1-16. Go to PubMed...
    21. Kotas R. Bolest hlavy v klinické praxi. Praha: Maxdorf, 2015: 312s.
    22. Kotas R. Tenzní typ bolesti hlavy - patofyziologie a léčba. Bolest 2013; 16(4): 157-160.
    23. Lainez MJ, Pascual J, Pascual AM, Santonja JM, Ponz A, Salvador A. Topiramat in the prophylactic treatment of cluster headache. Headache 2003; 43: 784-789. Go to original source... Go to PubMed...
    24. Lipton RB, Varon SF, Grosberg B, Mc Allister, Freitag F, Aurora SK. Onabotulinumtoxin A improves quality of life and reduces impact of chronic migraine. Neurology 2011; 77(15): 1465-1472. Go to original source... Go to PubMed...
    25. Mastík J. Migréna. Praha: Maxdorf, 2007: 104.
    26. May A, Leone M, Afra J, Linde M, Sandor PS, Evers S, Goadsby PJ. EFNS guidelines on the treatment of cluster headache and other trigeminal autonomic cephalgias. Eur J Neurol 2006; 13(10): 1066. Go to original source... Go to PubMed...
    27. Savi L. Lifestyle Therapy in migraine. Management and Therapeutic Strategies. Milano: One Way Publishing, 2008.
    28. Tepper SJ, Diener H-Ch, Ashina M, Brandes JL, Friedman D, Reuter U, Cheng S, Leonardi D, Lenz RA, Mikol DD. Efficacy of erenumab for the treatment of patients with chronic migraine in presence of medication overuse. Cephalalgia 2017; 37(Suppl. 1): 33-34.

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.