Sand T
Department of Neurology, University Hospital of Trondheim, Norway.
Funct Neurol. 1991 Jan-Mar;6(1):7-22.
EEG abnormalities in migraine have been reported by a number of authors during the last 50 years. Prevalences vary considerably in the older literature. A number of unspecific rhythms related to drowsiness or hyperventilation have probably been counted as "abnormal", and the reported numbers of definitely abnormal EEG rhythms have been consistently low. In a few controlled and blinded studies, however, slight excess of various EEG rhythms has been found in migraine patients. Similar prevalences of interictal EEG abnormalities have generally been found in patients with classic and common migraine, but the diagnostic classification may not have been precise enough in some studies. During visual aura, either slow waves, depression of background activity amplitude or normal EEG have been reported. The most definitely abnormal EEGs with unilateral or bilateral delta activity have been recorded during attacks of hemiplegic migraine, and during attacks of migraine with disturbed consciousness. The relationship between migraine and epilepsy has still not been adequately clarified. The connection seems to exist in several small entities (e.g. migraine-like headache as an epileptic manifestation, epileptic seizures triggered by epileptic attacks, and possibly in epilepsies with occipital spike waves), but it is seemingly not "fundamental". Newer methods, i.e. EEG frequency analysis and topographic brain mapping, are promising tools in this field. So far, mostly small studies have been published with somewhat inconsistent results. A pattern of increased alpha rhythm variability (and/or asymmetry) in the headache-free phase seems to emerge, however. Significant asymmetry of alpha and theta during headache has been reported in one topographic brain mapping study. Magnetoencephalographic studies of migraine patients have demonstrated slow wave-shifts (similar to those observed in animals with spreading depression). The EEG patterns observed in migraine patients seem to suggest a possible physiological connection between sleep, hyperventilation and migraine. The study of such relationship may shed new light on migraine pathophysiology.
在过去50年里，许多作者都报道过偏头痛患者存在脑电图（EEG）异常。早期文献中报道的患病率差异很大。一些与嗜睡或过度换气相关的非特异性节律可能被算作“异常”，而明确异常的EEG节律的报告数量一直很低。然而，在一些对照和盲法研究中，偏头痛患者中发现了各种EEG节律略有增加。典型偏头痛和普通偏头痛患者的发作间期EEG异常患病率通常相似，但在一些研究中，诊断分类可能不够精确。在视觉先兆期间，有报道称出现慢波、背景活动振幅降低或EEG正常。偏瘫性偏头痛发作期间以及意识障碍性偏头痛发作期间，记录到了最明确异常的单侧或双侧δ活动EEG。偏头痛与癫痫之间的关系仍未得到充分阐明。这种联系似乎存在于几个小的方面（例如，偏头痛样头痛作为癫痫表现、癫痫发作引发癫痫发作，以及可能存在枕叶棘波的癫痫），但似乎并非“根本”联系。更新的方法，即EEG频率分析和脑地形图，是该领域有前景的工具。到目前为止，大多是小规模研究发表，结果有些不一致。然而，在无头痛期似乎出现了α节律变异性增加（和/或不对称）的模式。一项脑地形图研究报告了头痛期间α和θ波的显著不对称。对偏头痛患者的脑磁图研究表明存在慢波移位（类似于在患有扩散性抑制的动物中观察到的情况）。在偏头痛患者中观察到的EEG模式似乎表明睡眠、过度换气和偏头痛之间可能存在生理联系。对这种关系的研究可能会为偏头痛的病理生理学带来新的启示。
