Der Schmerz
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Review Comparative Study
[Treatment of idiopathic headache in childhood - recommendations of the German Migraine and Headache Society (DMKG)].
According to the principles of evidence-based medicine, the controlled studies on the treatment of idiopathic headache in childhood have been analysed and compiled to treatment recommendations. For the acute treatment of migraine attacks or tension-type headache, ibuprofen (10 mg per kg body weight) or acetaminophen (15 mg per kg body weight) are recommended with highest evidence, intranasal sumatriptan (10 to 20 mg) can be given as second choice. ⋯ No controlled studies are available for the treatment of further headache types. First line methods for the non-drug treatment of headache in childhood are relaxation therapies, biofeedback, and specific training schedules.
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Gabapentin, which has been approved for add-on therapy of focal seizures, is increasingly used for treatment of neuropathic pain. Its analgesic effect is supposed to be due to reduction of glutamatergic transmission, improvement of GABAergic transmission and to binding to voltage-dependent calcium channels. Experimental studies demonstrated an ameliorating effect of gabapentin on neuropathic pain. ⋯ Case reports show an analgesic effect of gabapentin in trigeminus neuralgia and in reflex sympathetic dystrophy. The main adverse events are dizziness, ataxia and somnolence. Controlled studies, which compare the efficacy of gabapentin with that of the respective reference drug, are needed to evaluate its importance in treatment of pain.
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Clinical and experimental studies suggest that a generalized style of hypervigilant information processing may influence the pathogenesis of fibromyalgia (FM). This article deals with the question whether perception and processing of sensory stimuli in patients suffering from FM can be described in terms of "generalized hypervigilance". ⋯ On the whole the existing studies argue against the assumption of trait-like hypervigilant information processing in FM-patients. A more appropriate explanation of the results is in terms of the interaction of situational and personal factors.