會議議程
講者簡介
2022/8/13 08:30~11:50 Room B Hall (第二會議室) 1F
- Symposium (2) 自律神經暨暈眩、失智、頭痛
Update in Neurology
- Time
- Topic
- Speaker
- Moderator
- Professor 楊富吉
- MD, PhD
-
Chief, Division of Peripheral Nerve
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
E-mail：fuji-yang@yahoo.com.tw
Executive Summary：
現職
三軍總醫院神經科部周邊神經科 主任
國防醫學院神經學科 教授
台灣頭痛學會 理事
學經歷
國防醫學院醫學士
國立陽明大學腦科學研究所博士
國防醫學院神經學科 專任部定教授
三軍總醫院神經科部 病房主任、周邊神經科主任
三軍總醫院神經科部 住院醫師、總醫師、主治醫師
三軍總醫院神經科部加護中心 主治醫師
三軍總醫院澎湖、基隆分院 主治醫師
台灣神經學學會 副秘書長
台灣神經學學會教育委員會 委員
現職
三軍總醫院神經科部周邊神經科 主任
國防醫學院神經學科 教授
台灣頭痛學會 理事
學經歷
國防醫學院醫學士
國立陽明大學腦科學研究所博士
國防醫學院神經學科 專任部定教授
三軍總醫院神經科部 病房主任、周邊神經科主任
三軍總醫院神經科部 住院醫師、總醫師、主治醫師
三軍總醫院神經科部加護中心 主治醫師
三軍總醫院澎湖、基隆分院 主治醫師
台灣神經學學會 副秘書長
台灣神經學學會教育委員會 委員
Lecture Abstract：
Most cluster headaches occurring in Taiwan are episodic, and very few patients develop chronic cluster headaches. Treatment can be divided into acute and preventive types. Cluster headaches become extremely painful in a short period of time and are accompanied by ipsilateral autonomic symptoms; therefore, immediate treatment can bring considerable help to the patient.
Among the treatment methods currently available in Taiwan for cluster headaches, high-concentration pure oxygen inhalation has shown the best evidence level and effect in acute attacks, followed by the nasal spray form of Triptans, which is recommended as the first-line treatment. In terms of transitional preventive treatment, oral steroids and suboccipital steroid injections can be chosen. For maintenance prophylaxis, verapamil is recommended as first-line therapy. Drugs such as lithium, topiramate, and CGRP monoclonal antibody are recommended as second-line treatments. For instrumental therapy, non-invasive vagus nerve stimulation is recommended. For surgical treatment, Taiwan has no experience in its use presently, although the level of evidence and effect of sphenoid nerve stimulation are good.
Transitional prophylaxis and maintenance prophylaxis can be used simultaneously according to the individual condition of the patient, and the transitional prophylaxis can be gradually discontinued once the maintenance prophylaxis takes effect. Steroids not recommended to be used for more than 2 weeks in transitional prophylaxis. To maintain the timing of prophylaxis, the patient should wait for the end of the bout period (no attacks for 2 weeks), and then gradually tapered off the preventive medications.
Most cluster headaches occurring in Taiwan are episodic, and very few patients develop chronic cluster headaches. Treatment can be divided into acute and preventive types. Cluster headaches become extremely painful in a short period of time and are accompanied by ipsilateral autonomic symptoms; therefore, immediate treatment can bring considerable help to the patient.
Among the treatment methods currently available in Taiwan for cluster headaches, high-concentration pure oxygen inhalation has shown the best evidence level and effect in acute attacks, followed by the nasal spray form of Triptans, which is recommended as the first-line treatment. In terms of transitional preventive treatment, oral steroids and suboccipital steroid injections can be chosen. For maintenance prophylaxis, verapamil is recommended as first-line therapy. Drugs such as lithium, topiramate, and CGRP monoclonal antibody are recommended as second-line treatments. For instrumental therapy, non-invasive vagus nerve stimulation is recommended. For surgical treatment, Taiwan has no experience in its use presently, although the level of evidence and effect of sphenoid nerve stimulation are good.
Transitional prophylaxis and maintenance prophylaxis can be used simultaneously according to the individual condition of the patient, and the transitional prophylaxis can be gradually discontinued once the maintenance prophylaxis takes effect. Steroids not recommended to be used for more than 2 weeks in transitional prophylaxis. To maintain the timing of prophylaxis, the patient should wait for the end of the bout period (no attacks for 2 weeks), and then gradually tapered off the preventive medications.