Edmeads J
Sunnybrook Medical Centre, Division of Neurology, Toronto, Ontario, Canada.
Pathol Biol (Paris). 1992 Apr;40(4):279-83.
Migraine is a common condition with, usually, stereotyped symptomatology, suggesting that it is a specific disease entity (a morbus sui generis). However, occasionally a migraine sufferer will exhibit atypical manifestations of the condition; also, some specific diseases such as systemic lupus erythematosus and arteriovenous malformations, may exactly mimic the symptoms of migraine. These latter considerations raise the possibility that migraine is a syndrome rather than a disease. The recent delineation of the trigeminovascular system allows a conception of migraine as being neither disease nor syndrome, but rather a constitutional predisposition of the neurovascular system to react excessively to internal or external stimuli by a pattern of hyperactivity of the brain and of the trigeminovascular apparatus. Activation of the trigeminovascular system, whether by neural impulses from the brain or humoral factors in the circulation, results in vascular headaches, while associated activity in the brain may produce such typically migrainous symptomatology as prodrome and aura, and nonspecific symptoms such as nausea, vomiting and dizziness. In this model specific diseases may gain access to the trigeminovascular apparatus, detonating it to produce vascular headaches and neurological symptomatology which may more or less exactly mimic migraine.
偏头痛是一种常见病症，通常具有刻板的症状表现，这表明它是一种特定的疾病实体（一种独特的疾病）。然而，偏头痛患者偶尔会出现该病症的非典型表现；此外，一些特定疾病，如系统性红斑狼疮和动静脉畸形，可能会精确模拟偏头痛的症状。这些因素引发了一种可能性，即偏头痛是一种综合征而非一种疾病。最近对三叉神经血管系统的描述使人们认为偏头痛既不是疾病也不是综合征，而是神经血管系统的一种体质易感性，通过大脑和三叉神经血管装置的过度活跃模式，对内部或外部刺激做出过度反应。三叉神经血管系统的激活，无论是由来自大脑的神经冲动还是循环中的体液因素引起，都会导致血管性头痛，而大脑中的相关活动可能会产生诸如前驱症状和先兆等典型的偏头痛症状，以及诸如恶心、呕吐和头晕等非特异性症状。在这个模型中，特定疾病可能会影响三叉神经血管装置，引发其产生血管性头痛和神经症状，这些症状可能或多或少精确地模拟偏头痛。
