Prakt. Lékáren. 2018; 14(4e) [Neurol. praxi. 2018;19(3):193-198]

Primary headaches – treatment today and tomorrow

Jolana Marková, Rudolf Kotas
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 frequent primaryheadaches – migraine, tension type headache and cluster headache. The acute treatment of migraine attacks consists in the use of simple analgesics, non-steroidal anti-inflammatory drugs, ergotamines and triptans. Patients with frequent or long lasting attacks require the prophylactictreatment. So far beta-blockers, antiepileptic drugs, calcium channel blockers and antidepressants are used. Injections of onabotulinumtoxinA reduce the frequency of attacks in chronic migraine. The most promising new approach in the prophylactic treatment are monoclonal antibodiesable to block either CGRP or its receptor, such as erenumab, fremanezumab, galcanezumab, and eptinezumab. Tension type headacheis the most frequent type of headache. The treatment of acute attacks and prophylactic treatment in frequent episodic and chronic forms aredescribed. Cluster headache (CH) is a primary headache from the TACs group. The clinical manifestation and the existing knowledge aboutthe 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 9, 2019; Accepted: August 15, 2019; Prepublished online: August 15, 2019; Published: December 15, 2018  Show citation

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Marková J, Kotas R. Primary headaches – treatment today and tomorrow. Praktické lékárenství. 2018;14(E-verze 4/18):.
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