Tepper Stewart J
Center for Headache and Pain, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Curr Pain Headache Rep. 2008 Dec;12(6):463-7. doi: 10.1007/s11916-008-0078-2.
Differences between menstrually related migraine (MRM) and non-MRM are subtle. Preconception that population-based trials do not show differences, but that clinic-based trials showed severe, longer, and clinically refractory menstrual migraines, turns out to be simplistic. This review examines studies comparing and contrasting MRM and non-MRM. All of the pertinent studies show increase of migraine around menses. A judicious reading of the studies suggests that MRM is probably more severe in pain intensity than non-MRM. MRM is more disabling than non-MRM. MRM in clinics is more likely to have both worse prodrome and nausea. A significant subset of MRM patients has poorer response to acute medication. Overall, it appears that MRM is more severe than non-MRM when considering population- and clinic-based studies, with slightly but clinically meaningfully worse intensity, duration, disability, prodrome, nausea, and response to acute medications. Clinicians must have compassion and skill to manage patients with MRM.
月经相关性偏头痛（MRM）与非月经相关性偏头痛之间的差异很细微。基于人群的试验未显示出差异，但基于临床的试验表明月经性偏头痛严重、持续时间长且临床上难治，这种先入之见其实过于简单。本综述考察了比较和对比MRM与非MRM的研究。所有相关研究均显示经期前后偏头痛发作增加。对这些研究的审慎解读表明，MRM的疼痛强度可能比非MRM更严重。MRM比非MRM更具致残性。临床上的MRM更有可能同时伴有更严重的前驱症状和恶心。相当一部分MRM患者对急性药物治疗的反应较差。总体而言，从基于人群和临床的研究来看，MRM似乎比非MRM更严重，在强度、持续时间、致残性、前驱症状、恶心以及对急性药物的反应方面略差但具有临床意义。临床医生必须具备同情心和技能来管理MRM患者。
