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[与转换症状相关的偏头痛(巴宾斯基偏头痛):43例系列病例评估]

[Migraine associated with conversion symptoms (Babinski's migraine): evaluation of a series of 43 cases].

作者信息

García-Albea E

机构信息

Unidad de Cefaleas, Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, España.

出版信息

Neurologia. 2012 Apr;27(3):125-35. doi: 10.1016/j.nrl.2011.05.006. Epub 2011 Sep 1.

Abstract

BACKGROUND

In 1890 four cases of headache associated with visual symptoms and hysterical disorder were described by the French neurologist Babinski as migraine ophthalmique hystérique, or hysterical ophthalmic migraine. Since that time this association has seldom been described, and the possibly high frequency previously reported still remains to be established. This paper has reused Babinski's description and it tries to rehabilitate the syndrome described by the French semiologist across the relatively frequent experience of this type of patients in a public hospital. Also it analyzes the reason of the oblivion of his description.

METHOD

This study presents a series of 43 cases of headache of the migraine type associated with other symptoms, most consistent with basilar-type migraine according to IHS criteria. Diagnosis of conversion disorder (hysteria) was grounded in the criteria set forth in the DSM-IV.

RESULTS

All patients exhibited one or more manifestations of hysteria (conversion symptoms) during migraine attacks, and some did in the intervals between attacks as well. Details of the headaches, associated symptoms, and hysterical manifestations are discussed. Most patients improved with antimigraine medication. Altered consciousness may have contributed to the onset of hysterical symptoms.

CONCLUSIONS

The basilar type migraine associated with conversion symptoms described of systematized form by Babinski, it is not a rare entity. Similar pictures have been described along the history of the medicine. The later silence possibly is due to the historical difficulty in defining accurately the conversión disorders. The Babinskís migraine is a certain well entity and must be recovered for the clinic.

摘要

背景

1890年,法国神经学家巴宾斯基描述了4例伴有视觉症状和癔症性障碍的头痛病例,称为癔症性眼性偏头痛。自那时起,这种关联很少被描述,之前报道的可能的高发病率仍有待确定。本文重新采用了巴宾斯基的描述,并试图通过一家公立医院中这类患者相对常见的病例,使这位法国符号学家所描述的综合征得以重现。此外,本文还分析了其描述被遗忘的原因。

方法

本研究呈现了一系列43例伴有其他症状的偏头痛型头痛病例,根据国际头痛协会(IHS)标准,这些症状与基底型偏头痛最为相符。转换障碍(癔症)的诊断依据《精神疾病诊断与统计手册》第四版(DSM-IV)中规定的标准。

结果

所有患者在偏头痛发作期间均表现出一种或多种癔症表现(转换症状),有些患者在发作间期也有此类表现。文中讨论了头痛、相关症状及癔症表现的细节。大多数患者使用抗偏头痛药物后病情有所改善。意识改变可能促使了癔症症状的发作。

结论

巴宾斯基所描述的伴有转换症状的基底型偏头痛,并非罕见病症。医学史上也曾描述过类似病例。后来对此保持沉默可能是由于历史上难以准确界定转换障碍。巴宾斯基偏头痛是一种确切存在的病症,临床中必须重新认识它。

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