Chapter 5 - Paroxysmal headaches

Summary

According to the criteria of the International Headache Society (IHS), a migraine is defined as a disease with periodic occurring headache episodes, typically associated with autonomic symptoms. The release of neuropeptides explains the actual origin of pain but not how and why the attack begins so abruptly in humans. Triptans improves the typical additional symptoms like nausea or vomiting, photo- and photophobia, and improves the ability to return to work. During a migraine attack, most patients suffer from gastrointestinal symptoms. The aim of migraine prophylaxis is a reduction of frequency, severity and duration of migraine attacks and the prevention of medication overuse headache. Effective for preventive migraine therapy are the non-selective beta-blocker propranolol and the beta-1-selective beta-blocker metoprolol. Most psychological treatments used in migraine therapy are behavior therapies. Paroxysmal pain of short duration located in a region of one of the trigeminus nerves is very characteristic for the trigeminal neuralgia.