Barbour P J, Castaldo J E, Shoemaker E I
Department of Medicine, Division of Neurology, Lehigh Valley Hospital, Allentown, PA 18103, USA.
Headache. 2001 Mar;41(3):310-6. doi: 10.1046/j.1526-4610.2001.111006310.x.
This article discusses the pathophysiology and implications for treatment of hemiplegic migraine within a case study presentation.
We evaluated a 31-year-old white woman for hemiplegia in her 36th week of pregnancy. She initially presented with severe headache, dysarthria, lethargy, and left-sided numbness and weakness. Hemiplegic migraine remains a diagnosis made by exclusion; neurologic examination of these patients is localizing, but nonspecific.
Magnetic resonance imaging and single photon emission computed tomography scanning were performed on this patient during an exacerbation of headache associated with dense hemiplegia.
Magnetic resonance imaging showed a superficial cerebral hemispheric signal abnormality with enhancement. Single photon emission computed tomography scanning confirmed hyperperfusion of that hemisphere.
We believe the imaging evidence in our patient suggests that hemiplegia was caused and sustained by hyperperfusion. This case lends supportive evidence to a primarily vasodilatory mechanism and hyperperfusion as an etiology of the paralysis in such headaches and perhaps migraine with aura.
本文在一个病例研究报告中讨论偏瘫性偏头痛的病理生理学及其治疗意义。
我们对一名31岁的白人女性进行了评估，她在怀孕第36周时出现偏瘫。她最初表现为严重头痛、构音障碍、嗜睡以及左侧麻木和无力。偏瘫性偏头痛仍然是一种排除性诊断；对这些患者的神经系统检查具有定位作用，但缺乏特异性。
在该患者与严重偏瘫相关的头痛发作期间，进行了磁共振成像和单光子发射计算机断层扫描。
磁共振成像显示大脑半球浅表信号异常并伴有强化。单光子发射计算机断层扫描证实该半球存在血流灌注过多。
我们认为我们患者的影像学证据表明偏瘫是由血流灌注过多引起并持续存在的。该病例为主要的血管舒张机制以及血流灌注过多作为此类头痛甚至伴有先兆偏头痛中瘫痪的病因提供了支持性证据。
