![]() chronic tension-type headache (CTTH), chronic migraine (CM) or at least 1 year in e.g. In ICHD-3, chronic headache syndromes are defined by expert consensus as headache disorders that share characteristics with pre-existing headache syndromes, occur for a certain amount of time (at least 3 months in e.g. This criterion was omitted again in the latest and current Third Edition of the International Classification of Headache Disorders (ICHD-3). The criterion was changed in 2006 when a board of experts published revisions by consensus and introduced a broader concept of MOH, in which the diagnosis was based on headache frequency (equal to or greater than 15 days/month) and overuse of headache medication, but did not require the headache to improve after withdrawal. This caused the entity of definite MOH to be diagnosed retrospectively and more difficult to handle in clinical practice. The diagnostic criteria included a mandatory prerequisite that the headache syndrome resolved or reverted to the previous pattern within 2 months after discontinuation of the overused drug. It also defined MOH subtypes induced by simple analgesics, combination-analgesics, ergots, triptans and opioids. The term “medication-overuse headache” was first introduced in the second edition of the ICHD in 2004. proposed criteria for “transformed migraine”, since transformation of EM to daily or almost-daily head pain (> 15 days/month) was associated with medication overuse. After the introduction of triptans, it became clear that this class of drugs could also induce headache deterioration if used excessively. This was based on the experience with overuse of analgesics and ergots only. It also introduced and specified the entities “ergotamine-induced headache”, “analgesics abuse headache” and “other substances”. The first edition of the International Classification of Headache Disorders (ICHD) was published in 1988 which introduced the term “drug-induced headache”. outlined that overuse of analgesics contributed to the transformation of episodic migraine (EM) into daily headaches and a few years later the same group introduced the term “transformed or evolutive migraine” to describe the entity. In the 1970s, multiple authors wrote on the association between overuse of mixed analgesics, including those based on ergotamine, barbiturates and codeine, and headache progression. The first ergotamine withdrawal protocols were proposed independently by Graham, Friedman and Lippmann in 1955. ![]() The same authors published their withdrawal protocol in 1963. They reported on 52 migraine patients who developed daily headache after daily use of ergotamine and noted improvement after the drug was stopped. Chronic headache following overuse of ergotamine was clearly defined by Peters and Horton in 1951. The first descriptions of MOH date back to 1930s, when multiple authors started to associate prolongation of migraine with ergotamine-overuse. It provides an overview of the history, clinical features, epidemiology of MOH, an update on the current understanding of the underlying neurobiological mechanisms and treatment, before discussing the key topics in the controversies surrounding MOH. This review presents the current state of literature and knowledge on MOH. Debates on the pathophysiological mechanisms, definitions of overuse and the nosology of MOH are ongoing. ![]() MOH is widely accepted and recognised in the neurological and headache community nowadays, although the entity keeps raising important questions. The underlying consensus for the entity of medication-overuse headache (MOH) consists of a deterioration of a pre-existing headache syndrome whilst overusing one or several types of acute painkilling treatments. For more than 50 years, clinicians have recognized and reported on headache chronification occurring during a period of frequent use of analgesics. The use of analgesics is therefore justifiable when correctly utilized. Headache syndromes such as migraine or tension-type headache cause painful experiences and significant disability in patients. Overuse of symptomatic medication is a common problem in patients with primary headache syndromes.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |