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Erschienen in: Der Schmerz 2/2006

01.04.2006 | Übersichten

Alimentäre Triggerfaktoren bei Migräne und Kopfschmerz vom Spannungstyp

verfasst von: J. Holzhammer, Prof. Dr. C. Wöber

Erschienen in: Der Schmerz | Ausgabe 2/2006

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Zusammenfassung

Auf Basis eines Literaturüberblicks wird die Bedeutung alimentärer Triggerfaktoren bei Migräne und Kopfschmerz vom Spannungstyp (KST) kritisch diskutiert. Informationen beruhen überwiegend auf der subjektiven Einschätzung der Patienten. In kontrollierten Studien sind Alkoholkonsum und Koffeinentzug am besten als Triggerfaktoren von Kopfschmerzen belegt. Eingeschränkte Evidenz besteht für das Auslassen von Mahlzeiten. Als „neuer“, bislang kaum beachteter Triggerfaktor, verdient die Dehydrierung vermehrt Beachtung. Bei manchen Patienten wurde eine selektive Empfindlichkeit für Rotwein nachgewiesen, eine Kopfschmerztriggerung durch Schokolade darf ernsthaft bezweifelt werden, zur Bedeutung von Käse ist keine wissenschaftlich begründete Aussage möglich. Der experimentell gut belegten kopfschmerzauslösenden Wirkung von NO-Donatoren sowie parenteral verabreichtem Histamin stehen mangelnde Beweise dafür gegenüber, dass Histamin, Nitrite und Nitrate über die normale Nahrungsaufnahme Migräne oder KST auslösen. Ebenso wenig lässt sich aus den vorliegenden Daten auf eine solche Wirkung anderer biogener Amine sowie von Aspartam schließen. Natriumglutamat dürfte lediglich bei Zufuhr größerer Mengen auf nüchternem Magen zu Unverträglichkeitsreaktionen führen. Patienten mit Migräne und KST sollten über die begrenzte Bedeutung alimentärer Triggerfaktoren informiert und individuell beobachtete Unverträglichkeiten kritisch überprüft werden. Eindeutig bestätigte Trigger sollten vermieden werden. Allgemeine Diätempfehlungen lassen sich auf Basis des derzeitigen Wissensstands nicht begründen.
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Metadaten
Titel
Alimentäre Triggerfaktoren bei Migräne und Kopfschmerz vom Spannungstyp
verfasst von
J. Holzhammer
Prof. Dr. C. Wöber
Publikationsdatum
01.04.2006
Verlag
Springer-Verlag
Erschienen in
Der Schmerz / Ausgabe 2/2006
Print ISSN: 0932-433X
Elektronische ISSN: 1432-2129
DOI
https://doi.org/10.1007/s00482-005-0390-2