BLOQUEO NERVIOSO PERIFÉRICO COMO TRATAMIENTO QUIRÚRGICO DE LA CEFALEA POR USO EXCESIVO DE MEDICAMENTOS: INFORME DE DOS CASOS
DOI:
https://doi.org/10.53612/recisatec.v2i1.73Palabras clave:
cabeza por uso excesivo de medicamentos (EMC)Resumen
El dolor de cabeza por uso excesivo de medicamentos (EMC) es un dolor de cabeza secundario que ocurre durante 15 o más días por mes en pacientes con un diagnóstico preexistente de dolor de cabeza primario, que conduce al consumo excesivo regular de medicamentos para el dolor de cabeza sintomático durante 10 días en casos de ergotamina, triptantes, opioides y combinaciones de analgésicos, o durante más de 15 días en casos de analgésicos no opioides, paracetamol y medicamentos antiinflamatorios no esteroideos por mes durante más de 3 meses. La CEM es una de las enfermedades incapacitantes que ha tenido la incidencia más alta desde la década de 1990. La principal medida terapéutica es la retirada del medicamento sobreutilizado. Sin embargo, algunos pacientes no responden completamente al protocolo de retirada y, además, aquellos que mostraron mejoría, todavía tienen dolores de cabeza mensuales, aunque lo suficiente como para no ser diagnosticados con EMF. Los bloqueos anestésicos son un recurso para el manejo de diferentes cefaleas, ya sea como tratamiento aislado o combinado, o para el tratamiento de la cefalea de rebote después de la retirada del fármaco. Los anestésicos locales son capaces de interrumpir reversiblemente la conducción del impulso nervioso bloqueando los canales de sodio dependientes del voltaje a través de su fracción no ionizada, reduciendo así la excitabilidad celular. Por lo tanto, este estudio tuvo como objetivo informar el uso del bloqueo nervioso periférico como un tratamiento alternativo y efectivo para la CEM.
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