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[偏头痛的罕见和非典型形式]

[Rare and atypical forms of migraine].

作者信息

Géraud G

机构信息

Service de Neurologie, CHU Rangueil, 31403 Toulouse cedex 4, France.

出版信息

Rev Neurol (Paris). 2000;156 Suppl 4:4S42-6.

Abstract

There are three categories of rare forms of migraine headache. Atypical aura can raise difficult diagnostic questions due to their clinical expression (visual or sensorial illusions and hallucinations), their mode of onset (sudden aura, developing in less than 4 minute), their duration (prolonged aura lasting more than 60 minutes), and the lack of an accompanying headache. Differential diagnostics include partial epilepsy or AIT, requiring careful search for the underlying cause. Rare migraine syndromes are separate clinical entities, most of which are recognized by the International Headache Society (IHS). These syndromes include basilar migraine, familial hemiplegic migraine, ophthalmoplegic migraine and the exceptional retinal migraine. Confusional migraine, usually observed in children, is no individualized by the IHS but can be included here. For secondary migraines there is a triggering factor leading to migraine in patients with no history of migraine previously. These include post-traumatic migraine and cervical migraine as well as migraine occurring with epileptic seizures and rare symptomatic migraine headache disclosing a general disease or an intracranial neurological lesion.

摘要

偏头痛有三种罕见类型。非典型先兆因其临床表现(视觉或感觉错觉及幻觉)、起病方式(突发先兆,在4分钟内出现)、持续时间(持续超过60分钟的延长先兆)以及无伴随头痛,会引发诊断难题。鉴别诊断包括部分癫痫或短暂性全面遗忘症,需要仔细寻找潜在病因。罕见偏头痛综合征是独立的临床实体,其中大多数已被国际头痛协会(IHS)认可。这些综合征包括基底型偏头痛、家族性偏瘫性偏头痛、眼肌麻痹性偏头痛以及罕见的视网膜偏头痛。混乱型偏头痛通常在儿童中观察到,IHS未将其单独分类,但可在此处包含。继发性偏头痛存在一个触发因素,导致既往无偏头痛病史的患者出现偏头痛。这些包括创伤后偏头痛和颈性偏头痛,以及与癫痫发作相关的偏头痛和罕见的症状性偏头痛性头痛,后者揭示了一种全身性疾病或颅内神经病变。

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