Olesen J
Department of Neurology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Eur Neurol. 1990;30 Suppl 2:31-4; discussion 39-41. doi: 10.1159/000117189.
Three primary mechanisms have been suggested as an explanation of migraine; a neuronal event, a vascular event and a mechanism focussing on the trigeminal nerve and its supply to intra- and extracranial blood vessels. None of these theories has been adequately proven yet. A neuronal point of impact, rather than a vascular one, seems to be responsible for migraine prophylaxis with calcium antagonists. Primarily vasoactive substances such as nimodipine are not or only marginally effective, whereas flunarizine with a limited vascular activity is effective. Data on other calcium antagonists are insufficient to conclude on a migraine-prophylactic activity. The only calcium antagonist that has been extensively tested for vertigo is flunarizine. In placebo-controlled trials, the drug showed to be effective in labyrinthine vertigo. The mechanism behind this effect is unclear.
关于偏头痛的发病机制，目前主要有三种假说：神经元学说、血管学说以及聚焦于三叉神经及其对颅内和颅外血管供血的机制。然而，这些理论均未得到充分证实。钙拮抗剂预防偏头痛的作用机制似乎是作用于神经元靶点，而非血管靶点。像尼莫地平这类主要的血管活性物质对预防偏头痛无效或仅有微弱效果，而血管活性有限的氟桂利嗪则有效。其他钙拮抗剂预防偏头痛作用的数据不足，无法得出相关结论。唯一一种针对眩晕进行了广泛测试的钙拮抗剂是氟桂利嗪。在安慰剂对照试验中，该药物对迷路性眩晕有效。这种作用背后的机制尚不清楚。
