Thomsen Lise L, Ostergaard Elsebet, Olesen Jes, Russell Michael B
Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
Neurology. 2003 Feb 25;60(4):595-601. doi: 10.1212/01.wnl.0000046524.25369.7d.
To compare clinical characteristics of patients with sporadic hemiplegic migraine (SHM) with those of patients with migraine with typical aura (MA) and patients with familial hemiplegic migraine (FHM).
The authors used a computer search of Denmark's National Patient Register to screen the population for patients with migraine with aura with motor weakness, and also examined case records from headache clinics and private practicing neurologists and placed advertisements. The authors screened patients and their relatives with a semi-structured validated telephone interview. All recruited patients were then interviewed by a physician and given a neurologic examination.
A total of 105 patients with SHM were identified. Seventy-two percent had four typical aura symptoms: visual, sensory, aphasic, and motor. All had at least two symptoms present during SHM attacks. A gradual progression and sequential appearance of aura symptoms was typical; compared with MA, the duration of each aura symptom was usually prolonged and bilateral motor symptoms were more frequent. Of the patients with SHM, 72% fulfilled the criteria for basilar migraine during SHM attacks. The aura was usually followed by headache, as is common in FHM but not MA.
Patients with sporadic hemiplegic migraine had clinical symptoms identical to familial hemiplegic migraine and significantly different from migraine with typical aura. Sporadic hemiplegic migraine is a separate entity, and should be classified with familial hemiplegic migraine.
比较散发性偏瘫性偏头痛（SHM）患者与典型先兆偏头痛（MA）患者及家族性偏瘫性偏头痛（FHM）患者的临床特征。
作者通过计算机检索丹麦国家患者登记册，以筛查有先兆且伴有运动无力的偏头痛患者，还查阅了头痛诊所及私人执业神经科医生的病例记录并发布了广告。作者通过半结构化有效电话访谈对患者及其亲属进行筛查。所有招募的患者随后均接受医生访谈并进行神经系统检查。
共识别出105例散发性偏瘫性偏头痛患者。72%的患者有四种典型先兆症状：视觉、感觉、失语和运动症状。在散发性偏瘫性偏头痛发作期间，所有患者至少有两种症状出现。先兆症状典型地呈逐渐进展和相继出现；与典型先兆偏头痛相比，每种先兆症状的持续时间通常更长，双侧运动症状更常见。在散发性偏瘫性偏头痛患者中，72%在发作期间符合基底型偏头痛的标准。先兆之后通常会出现头痛，这在家族性偏瘫性偏头痛中常见，但在典型先兆偏头痛中不常见。
散发性偏瘫性偏头痛患者的临床症状与家族性偏瘫性偏头痛相同，与典型先兆偏头痛显著不同。散发性偏瘫性偏头痛是一个独立的疾病实体，应与家族性偏瘫性偏头痛归为一类。
