Diagnosis dan tatalaksana cervicogenic headache

Abstract

Acute Cervicogenic headache (CGH) is a type of secondary headache originating from cervical structures and soft tissues in the neck. CGH is often challenging to diagnose due to overlapping symptoms with other types of headaches, such as migraines and tension-type headaches (TTH). The diagnosis of CGH is based on clinical criteria from the Cervicogenic Headache International Study Group (CHISG) and The International Classification of Headache Disorders 3rd edition (ICHD-3), which include unilateral pain triggered by neck movements and confirmation through anesthetic nerve blocks. The management of CGH consists of non-pharmacological, pharmacological, and interventional approaches. on-pharmacological treatments include physiotherapy, manual therapy, and modalities such as transcutaneous electrical nerve stimulation (TENS). Pharmacological therapies involve the use of non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and antiepileptic drugs. Meanwhile, interventional therapies include occipital nerve blocks, facet block or cervical nerve block, and dry needling. A multidisciplinary approach in the diagnosis and management of CGH is essential to improve treatment effectiveness and enhance patients' quality of life. Further research is needed to develop more effective therapies and optimize pain management in CGH patients.ABSTRAK

Cervicogenic headache (CGH) adalah jenis nyeri kepala sekunder yang berasal dari struktur servikal dan jaringan lunak di leher. CGH sering kali sulit didiagnosis karena memiliki gejala yang tumpang tindih dengan jenis nyeri kepala lainnya, seperti migrain dan tension-type headache (TTH). Diagnosis CGH didasarkan pada kriteria klinis dari Cervicogenic Headache International Study Group (CHISG) dan The International Classification of Headache Disorders 3rd edition (ICHD-3), yang mencakup nyeri unilateral dipicu oleh gerakan leher dan dapat dikonfirmasi dengan blok anestesi. Tatalaksana CGH terdiri dari pendekatan nonfarmakologis, farmakologis, dan intervensional. Pendekatan nonfarmakologis meliputi fisioterapi, terapi manual, serta penggunaan modalitas seperti transcutaneous electrical nerve stimulation (TENS). Terapi farmakologis meliputi penggunaan non-steroidal anti-inflammatory drugs (NSAID), relaksan otot, antidepresan, dan obat antiepilepsi. Sementara itu, terapi intervensional mencakup blok saraf oksipital, facet block maupun blok saraf area servikal, dan dry needling. Pendekatan multidisiplin dalam diagnosis dan tatalaksana CGH sangat diperlukan untuk meningkatkan efektivitas pengobatan dan kualitas hidup pasien. Penelitian lebih lanjut masih dibutuhkan untuk mengembangkan terapi yang lebih efektif dan mengoptimalkan manajemen nyeri pada pasien dengan CGH.