Wolthausen J, Sternberg S, Gerloff C, May A
Department of Neurology, University of Hamburg, Hamburg, Germany.
Cephalalgia. 2009 Feb;29(2):244-9. doi: 10.1111/j.1468-2982.2008.01713.x. Epub 2008 Nov 18.
During the past few decades, much controversy has surrounded the pathophysiology of migraine. Cortical spreading depression (CSD) is widely accepted as the neuronal process underlying visual auras. It has been proposed that CSD can also cause the headaches, at least in migraine with aura. We describe three patients, each fulfilling the International Headache Society criteria for migraine with aura, who suffered from headaches 6-10 days per month. Two patients were treated with flunarizine and the third patient with topiramate for the duration of 4 months. All patients reported that aura symptoms resolved completely, whereas the migraine headache attacks persisted or even increased. These observations question the theory that CSD (silent or not) is a prerequisite for migraine headaches.
在过去几十年里，偏头痛的病理生理学一直备受争议。皮层扩散性抑制（CSD）被广泛认为是视觉先兆背后的神经过程。有人提出，CSD也可导致头痛，至少在有先兆的偏头痛中如此。我们描述了三名患者，他们均符合国际头痛协会有先兆偏头痛的标准，每月头痛6 - 10天。两名患者接受了4个月的氟桂利嗪治疗，第三名患者接受了4个月的托吡酯治疗。所有患者均报告先兆症状完全消失，而偏头痛发作持续存在甚至增多。这些观察结果对CSD（无论是否无症状）是偏头痛头痛的先决条件这一理论提出了质疑。
