Nadkar Milind Y, Desai Sandeep D, Itolikar Manish W
Department of Medicine, Seth G S Medical College & KEM Hospital, Parel, Mumbai 400012.
J Assoc Physicians India. 2010 Apr;58 Suppl:10-3.
Although the understanding of the pathophysiology and the pharmacology of migraine has exploded there are still many pitfalls that may occur in the clinical assessment and management of migraine. This may prevent the patient from receiving optimal treatment. A diagnosis of migraine may be missed in the presence of other headache types that occur more frequently than migraine. Also, migraine may be misdiagnosed when treating physicians inappropriately interpret specific symptoms and co-morbid conditions as indicators of the presence of a non-migraine headache type such as sinus headache or tension headache. Migraine and tension-type headache share common triggers and this also contributes to the difficulty in their differential diagnosis. The non-availability of any diagnostic laboratory investigation only makes this job further difficult.
尽管对偏头痛的病理生理学和药理学的认识有了极大的进展，但在偏头痛的临床评估和管理中仍可能存在许多陷阱。这可能会使患者无法获得最佳治疗。当存在比偏头痛更频繁发生的其他头痛类型时，可能会漏诊偏头痛。此外，当治疗医生将特定症状和共病情况错误地解释为非偏头痛性头痛类型（如鼻窦头痛或紧张性头痛）存在的指标时，偏头痛可能会被误诊。偏头痛和紧张型头痛有共同的触发因素，这也增加了它们鉴别诊断的难度。任何诊断性实验室检查都无法进行，只会使这项工作更加困难。
