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Yıl:2010; Cilt: 47; Sayı: 4>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2010;47(4):279-285
Trigeminal Otonomik Sefaljilerde Tedavi
HM Selekler, SN Altun
Kocaeli Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Kocaeli, Türkiye
Trigeminal otonomik sefaljiler-küme başağrısı, paroksismal hemicrania (PH), hemicrania continua (HC) ve SUNCT (short-lasting unilateral headache attacks with conjunctival injection and tearing) - ünilateral ağrıya eşlik eden ipsilateral otonomik bulgular ile karakterizedirler. Küme başağrısının oturmuş bir medikal tedavisi mevcuttur. Bununla beraber kronik formların tedavisi sorun yaratabilmektedir. PH ve HC'nın ana tedavileri indomethacin'e dayanmaktadır. İndomethacin'i n kontrendike olduğu hallerde ve yerine koyulacak başka bir ilaç gerektiğinde güçlükler oluşabilir. SUNCT tedavisinde lamotrigine en fazla öne çıkan ilaç olsa da, indomethacin gibi anahtar bir molekül değildir. Son 10 yılda geliştirilen oksipital sinir stimülasyonu ve hipotalamik stimülasyon gibi cerrahi yöntemler medikal tedaviye dirençli trigeminal otonomik sefaljili hastalar için umut vaad etmektedir.
Therapy in Trigeminal Autonomic Cephalgias
Trigeminal autonomic cephalgias - cluster headache, paroxysmal hemicrania (PH), hemicrania continua (HC) and SUNCT (short-lasting unilateral headache attacks with conjunctival injection and tearing)-are characterized by ipsilateral autonumic features accompanying the unilateral headache. A well-established medical treatment exists for cluster headache. However, problems could arise when treating chronic forms. Main treatment option for PH and HC is indomethacin. Troubles may occur when indomethacin is contrindicated and when replacing it with another agent is needed. Although lamorigine is the most well-known drug in SUNCT treatment, it is not a key drug such as indomethacin. Surgical procedures (e.g. occipital nerve stimulation and hypothalamic stimulation), which have been developed in the last ten [year]s, are promising in the treatment of drug-resistant trigeminal autonomic cephalgia patients.

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