Der Schmerz
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Episodic tension type headache is considered to be the most prevalent primary headache. If tension type headache occurs on more than 15 days per month for at least 3 consecutive months, it is classified as chronic tension type headache. ⋯ In the paper, we discuss how the differential diagnosis can be more specific and which therapy is supported by the literature. In addition, we discuss differences and similarities of tension type headache and migraine and a possible similar pathophysiology of both (convergence hypothesis).
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Digitalization offers support and innovative approaches in the diagnosis and therapy of headaches. With the German digital health care act (Digitale-Versorgung-Gesetz) it is now possible to integrate this into regular care for the first time. However, it is currently difficult to assess the various offers; quality standards and conclusive studies to determine the efficacy and safety are missing. ⋯ Different digital approaches could support practitioners and patients effectively in headache treatment and therapy guidance in the near future. However, high-quality studies are necessary to evaluate their benefits and efficacy.
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In the past 10 years specific pathways for pruritus have been characterized on a cellular and molecular level but their exact role in the pathophysiology of neuropathic pruritus remains unclear. This also applies to the question which of the competing theories for pruritus, e.g. specificity, temporal/spatial pattern or intensity, would best apply. ⋯ The skin innervation is greatly reduced by the neuropathy and could provide a "spatial contrast pattern" and the axotomy could induce a de novo expression of gastrin-releasing peptide (GRP) in primarily afferent nociceptors and thus modulate spinal pruritus processing. In addition, the overlap of pruritus and pain in neuropathy patients complicates the direct translation from animal experiments and requires collaboration at the clinical level between pain medicine and dermatology.