[Positioning of headache units in the field of neurology: the importance of OnabotulinumtoxinA and other therapies in the treatment of headaches].
Chronic migraine is a disease that affects 0.5-2.5% of the population, depending on the statistics that are analysed and the definition of chronic migraine that is used. It is extraordinarily disabling, since it does not allow the sufferer to carry out any of their scheduled personal, professional or social activities, and it has a great impact on the patients' quality of life, as measured on disability, quality of life and impact on daily activities scales. Yet, nowadays there are treatments that have proven to be effective in cases of chronic migraine, such as OnabotulinumtoxinA. It is a treatment that is well tolerated and with a high rate of efficacy. Yet it is not only a therapeutic tool, but in the world of headaches it has also opened up the doors to invasive treatments, to the learning of techniques and, in short, to placing headaches in referral units that are usually located in tertiary care hospitals. Furthermore, it has also helped to overcome the idea that patients with headache should be visited exclusively by primary care physicians or general neurologists. This is an opportunity to redefine the field of study and the care for headaches that must be seized. In the future, this is going to be complemented by novel treatments with neurostimulation and probably with monoclonal antibodies against the calcitonin gene-related peptide. A revolution has begun in our knowledge and capacity to act. It is our duty to give it the importance and usage it deserves both for our patients and for us as specialists.
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Torres-Ferrus
Hospitals Vall d'Hebron, 08035 Barcelona, Espana.
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Pozo-Rosich
D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002116:Calcitonin / Q000037:antagonists & inhibitors; D003027:Cluster Headache / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D004599:Electric Stimulation Therapy; D005544:Forecasting; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D020773:Headache Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D006757:Hospital Units / Q000600:supply & distribution; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D009407:Nerve Block; D009437:Neuralgia / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D009462:Neurology / Q000458:organization & administration*; D015995:Prevalence; D011498:Protein Precursors / Q000037:antagonists & inhibitors; D013030:Spain / Q000453:epidemiology; D035703:Therapies, Investigational; D000077236:Topiramate; D014481:United States / Q000453:epidemiology
D065087:Acetylcholine Release Inhibitors; D000911:Antibodies, Monoclonal; D011498:Protein Precursors; D000077236:Topiramate; D005632:Fructose; D002116:Calcitonin; D019274:Botulinum Toxins, Type A