Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH). The management of MOH requires three steps: (1) education, (2) withdrawal of the overuse drug and detoxification, and (3) re-prophylaxis. In the last years, several real-life prospective studies provided further evidence in clinical setting of the onabotulinumtoxinA 155-195 U efficacy for the headache prophylaxis in CM with MOH patients. There is a general agreement on two factors: (1) withdrawal of the overuse drug is condicio sine qua non to reverse the pattern to medium-low-frequency migraine, and (2) the focus of management needs to shift from acute treatment of pain to prevention of headache. CM patients close to developing MOH, patients with high-frequency episodic migraine, and those already abusing of drugs require special attention and should refer to tertiary headache centers. For all of them, a solution could be an "early treatment." Early should be their referral to a tertiary headache center, early should be the withdrawal of the overuse drug and a proper detoxification, and perhaps early should be the start of a preventative therapy.
A critical evaluation on MOH current treatments / Negro, Andrea; Curto, Martina; Lionetto, Luana; Guerzoni, Simona; Pini, Luigi Alberto; Martelletti, Paolo. - In: CURRENT TREATMENT OPTIONS IN NEUROLOGY. - ISSN 1092-8480. - ELETTRONICO. - 19:9(2017), pp. 1-13. [10.1007/s11940-017-0465-2]
|Titolo:||A critical evaluation on MOH current treatments|
NEGRO, ANDREA (Primo) [Writing – Original Draft Preparation] (Corresponding author)
|Data di pubblicazione:||2017|
|Citazione:||A critical evaluation on MOH current treatments / Negro, Andrea; Curto, Martina; Lionetto, Luana; Guerzoni, Simona; Pini, Luigi Alberto; Martelletti, Paolo. - In: CURRENT TREATMENT OPTIONS IN NEUROLOGY. - ISSN 1092-8480. - ELETTRONICO. - 19:9(2017), pp. 1-13. [10.1007/s11940-017-0465-2]|
|Appartiene alla tipologia:||01g Articolo di rassegna (Review)|