Gibt es einen psychogenen Kopfschmerz?

2018 ◽  
Vol 37 (01/02) ◽  
pp. 38-42
Author(s):  
K. Henkel

ZusammenfassungEs besteht eine hohe Komorbidität zwischen primären Kopfschmerzen und psychischen Erkrankungen. Eine gegenseitige Verstärkung und gemeinsame ätiologische Faktoren werden vermutet und wurden zum Teil nachgewiesen, so zum Beispiel bei Migräne und Depressionen. Eine nosologische Einteilung als sekundärer “Kopfschmerz zurückzuführen auf eine psychiatrische Störung“ verlangt eine hinreichende Evidenz für eine Auslösung oder wesentliche Verstärkung des Kopfschmerzes durch die psychische Erkrankung. Dieser Nachweis kann nur in Einzelfällen erfolgen. Größere systematische Untersuchungen fehlen. Die International Classification of Headache Disorders der International Headache Society erkennt auch in ihrer dritten Auflage (Beta-Version) nur die Somatisierungsstörung und die psychotische Störung als mögliche psychische Erkrankungen für die Auslösung sekundärer Kopfschmerzen an. Im Anhang der Klassifikation finden sich weitere psychische Erkrankungen, die möglicherweise sekundäre Kopfschmerzen auslösen können. Weitere prospektive und Längsschnittstudien sind nötig, um diese Zusammenhänge künftig besser beurteilen zu können.

2018 ◽  
Vol 37 (01) ◽  
pp. 38-42 ◽  
Author(s):  
K. Henkel

ZusammenfassungEs besteht eine hohe Komorbidität zwischen primären Kopfschmerzen und psychischen Erkrankungen. Eine gegenseitige Verstärkung und gemeinsame ätiologische Faktoren werden vermutet und wurden zum Teil nachgewiesen, so zum Beispiel bei Migräne und Depressionen. Eine nosologische Einteilung als sekundärer “Kopfschmerz zurückzuführen auf eine psychiatrische Störung“ verlangt eine hinreichende Evidenz für eine Auslösung oder wesentliche Verstärkung des Kopfschmerzes durch die psychische Erkrankung. Dieser Nachweis kann nur in Einzelfällen erfolgen. Größere systematische Untersuchungen fehlen. Die International Classification of Headache Disorders der International Headache Society erkennt auch in ihrer dritten Auflage (Beta-Version) nur die Somatisierungsstörung und die psychotische Störung als mögliche psychische Erkrankungen für die Auslösung sekundärer Kopfschmerzen an. Im Anhang der Klassifikation finden sich weitere psychische Erkrankungen, die möglicherweise sekundäre Kopfschmerzen auslösen können. Weitere prospektive und Längsschnittstudien sind nötig, um diese Zusammenhänge künftig besser beurteilen zu können.


Author(s):  
Jonathan P. Gladstone ◽  
David W. Dodick

In 1988, the International Headache Society created a classification system that has become the standard for headache diagnosis and research. The International Classification of Headache Disorders galvanized the headache community and stimulated nosologic, epidemiologic, pathophysiologic, and genetic research. It also facilitated multinational clinical drug trials that have led to the basis of current treatment guidelines. While there have been criticisms, the classification received widespread support by headache societies around the globe. Fifteen years later, the International Headache Society released the revised and expanded International Classification of Headache Disorders second edition. The unprecedented and rapid advances in the field of headache led to the inclusion of many new primary and secondary headache disorders in the revised classification. Using illustrative cases, this review highlights 10 important new headache types that have been added to the second edition. It is important for neurologists to familiarize themselves with the diagnostic criteria for the frequently encountered primary headache disorders and to be able to access the classification (www.i-h-s.org) for the less commonly encountered or diagnostically challenging presentations of headache and facial pain.


Cephalalgia ◽  
2017 ◽  
Vol 38 (10) ◽  
pp. 1696-1700 ◽  
Author(s):  
Evan Mullen ◽  
Mark Green ◽  
Eliza Hersh ◽  
Alfred-Marc Iloreta ◽  
Joshua Bederson ◽  
...  

Introduction The term Tolosa-Hunt Syndrome was first used more than half a century ago to describe painful ophthalmoplegia accompanied by cranial nerve palsies. In the decades since, its diagnostic criteria have evolved considerably. The beta version of the 3rd Edition of the International Classification of Headache Disorders narrows these criteria to require the demonstration of granulomatous inflammation on MRI or biopsy. We believe this may introduce challenges to accurate diagnosis. Discussion Requiring the demonstration of granulomatous inflammation for a diagnosis of Tolosa-Hunt Syndrome may introduce the potential for false negative and false positive diagnoses. Although the disorder presents secondary to granulomatous inflammation, MRI technology may not be able to identify it reliably, and biopsy is not always indicated for its symptomatology. Additionally, several cases have been reported of Tolosa-Hunt Syndrome diagnosed with MRI-confirmed granulomatous inflammation that later prove to be attributable to other pathologies. The emphasis on neuroimaging may therefore exclude some true Tolosa-Hunt Syndrome cases and include others resulting from other latent pathologies that are not visible on MRI. Conclusion We wish to offer several potential modifications to the International Classification of Headache Disorders guidelines for Tolosa-Hunt Syndrome, including making the demonstration of granulomatous inflammation on MRI or biopsy non-mandatory and lengthening patient follow-up to two years for cases in which MRI is unrevealing.


2016 ◽  
Vol 31 (1) ◽  
pp. 106 ◽  
Author(s):  
Byung-Kun Kim ◽  
Soo-Jin Cho ◽  
Byung-Su Kim ◽  
Jong-Hee Sohn ◽  
Soo-Kyoung Kim ◽  
...  

Cephalalgia ◽  
2007 ◽  
Vol 27 (3) ◽  
pp. 230-234 ◽  
Author(s):  
ME Bigal ◽  
AM Rapoport ◽  
FD Sheftell ◽  
SJ Tepper ◽  
RB Lipton

In the absence of a biological marker and expert consensus on the best approach to classify chronic migraine (CM), recent revised criteria for this disease has been proposed by the Headache Classification Committee of the International Headache Society. This revised criteria for CM is now presented in the Appendix. Herein we field test the revised criteria for CM. We included individuals with transformed migraine with or without medication overuse (TM+ and TM-), according to the criteria proposed by Silberstein and Lipton, since this criterion has been largely used before the Second Edition of the International Classification of the Headache Disorders (ICHD-2). We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+), as well as the revised ICHD-2 (ICHD-2R) criteria for CM (≥15 days of headache, ≥8 days of migraine or migraine-specific acute medication use—ergotamine or triptans). We also tested the ICHD-2R vs. three proposals. In proposal 1, CM/CM+ would require at least 15 days of migraine or probable migraine per month. Proposal 2 required ≥15 days of headache per month and at least 50% of these days were migraine or probable migraine. Proposal 3 required ≥15 days of headache and at least 8 days of migraine or probable migraine per month. Of the 158 patients with TM-, just 5.6% met ICHD-2 criteria for CM. According to the ICHD-2R, a total of 92.4% met criteria for CM ( P < 0.001 vs. ICHD-2). The ICHD-2R criterion performed better than proposal 1 (47.8% of agreement, P < 0.01) and was not statistically different from proposals 2 (87.9%) and 3 (94.9%). Subjects with TM+ should be classified as medication overuse headache (MOH), and not CM+, according to the ICHD-2R. Nonetheless, we assessed the proportion of them who had ≥8 days of migraine per month. Of the 399 individuals with TM+, just 10.2% could be classified as CM+ in the ICHD-2. However, most (349, 86.9%) had ≥8 days of migraine per month and could be classified as MOH and probable CM in the ICHD-2R ( P < 0.001 vs. ICHD-2). We conclude that the ICHD-2R addresses most of the criticism towards the ICHD-2 and should be adopted in clinical practice and research. In the population where use of specific acute migraine medications is less common, the agreement between ICHD-2R CM and TM may be less robust.


2014 ◽  
pp. 14-20
Author(s):  
Manuella Moraes Monteiro Barbosa Barros ◽  
Angélica da Silva Tonório ◽  
Thaís Ferreira Lopes Diniz Maia ◽  
Camila Carolinne Silva de Almeida ◽  
Daniella Araújo de Oliveira

Introdução: As cefaleias constituem a sintomatologia neurológica mais comum em todo o mundo; a presença desta alteração pode promover diversas consequências na biomecânica dos músculos cervicais, que podem limitar a mobilidade cervical e causar prejuízos aos pacientes que sofrem com cefaleia. Objetivo: Avaliar a relação entre a presença de cefaleia primária e a restrição na amplitude de movimento cervical. Métodos: Foi realizado um estudo piloto com 33 indivíduos (27 mulheres) com idade entre 20 e 38 anos (26 ± 5 anos). Para avaliar a mobilidade cervical ativa foi utilizado o goniômetro universal. O grau de disfunção cervical foiavaliado pelo questionário de Índice de Disfunção relacionado ao Pescoço. Para classificar a cefaleia primária foram utilizados os critérios estabelecidos pela International Classification of Headache Disorders (ICHD-III beta version, 2013). Resultados: Não houve diferenças estatísticas entre os grupos em relação ao gênero e última crise de cefaleia. A mobilidade cervical apresentou diferenças entre os grupos com cefaleia e saudáveis, mas essas não foram estatisticamente significantes. Também houve diferenças entre os grupos cefaleia e saudáveis em relação à classificação do Índice de Disfunção relacionado ao Pescoço, sem diferença significante (p<0,05). Conclusão: O estudo não demonstrou diferença entre a mobilidade cervical em pacientes com cefaleia primária, quando comparados a indivíduos saudáveis.


Sign in / Sign up

Export Citation Format

Share Document