Migräne – Pathophysiologie und nicht-medikamentöse Behandlung

Abstract

Migraine – Pathophysiological aspects and non-pharmacological treatment

The pathophysiology of migraine is complex. According to a diathesis-stress-model, stressful stimuli trigger a migraine attack on the background of a primary neurological function deficite (diathesis). Although the discurbances are of a neurological nature, recommendations for the treatment of migraine include both pharmacological and non-pharmacological approaches. Non-pharmacological approaches enable the patient to a higher responsibility andsflf-efficacy in coping with migraine. Therefore, the active involvement of the patient in the treatment is obligatory in all psychological pain therapy methods. The focus of non-pharmacological therapy is on emotional, cognitive, behavioural and social factors of migraine, with the aim to modify unfavourable habits and migraine attack-inducing factors. Among non-pharmacological methods, counselling, relaxation training, biofeedback and cognitive-behavioural treatments are employed. The long-term effects of these methods are comparable to those of prophylactic pharmacological treatment. Combination of pharmacological and non-pharmacological treatment leads to even higher efficacy and is often indicated. In case of headache in children, behavioural therapy should be the method of first choice. In this paper, empirically proven methods of psychological pain therapy in migraine are presented.