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法国一家三级医疗中心中偏头痛引发的短暂性全面性遗忘症:一项11年的回顾性分析。

Transient Global Amnesia Triggered by Migraine in a French Tertiary-Care Center: An 11-Year Retrospective Analysis.

作者信息

Donnet Anne

机构信息

Centre d'Evaluation et de Traitement de la Douleur, Hôpital Timone, Marseille, France.

出版信息

Headache. 2015 Jun;55(6):853-9. doi: 10.1111/head.12545. Epub 2015 Apr 15.

Abstract

OBJECTIVE

The etiology of transient global amnesia (TGA) remains unclear, and flow disturbances in the mesial temporal lobes secondary to venous congestion have been proposed as a potential cause. The occurrence of TGA during a migraine attack is a rare condition.

METHODS

This 11-year retrospective study in one French center describes patients' characteristics, type of migraine, investigations, treatment with vasoconstrictor during the TGA/migraine attack, and outcome in patients who had TGA during a migraine attack.

RESULTS

Among 8821 new patients, 6 cases of TGA occurring during a migraine attack were identified. For a majority of patients, TGA occurs after the beginning of the attack. TGA always occurs during a severe migraine attack, with vomiting or vomiting efforts. Vomiting or vomiting efforts always precede a TGA episode.

CONCLUSIONS

TGA occurring during a migraine attack is rare. Since a Valsalva maneuver, such as forceful vomiting, is frequently described at the origin of the attack, blocking venous return through the superior venous cava may allow brief retrograde transmission of high venous pressure from the arms to the cerebral venous system, resulting in venous ischemia to the diencephalon or mesial temporal lobes and causing TGA.

摘要

目的

短暂性全面性遗忘症(TGA)的病因仍不清楚,有人提出继发于静脉淤血的内侧颞叶血流紊乱是一个潜在原因。偏头痛发作期间发生TGA的情况较为罕见。

方法

在法国的一个中心进行的这项为期11年的回顾性研究描述了患者的特征、偏头痛类型、检查、TGA/偏头痛发作期间使用血管收缩剂的治疗情况以及偏头痛发作期间发生TGA的患者的结局。

结果

在8821名新患者中,识别出6例偏头痛发作期间发生TGA的病例。对于大多数患者来说,TGA在发作开始后出现。TGA总是在严重偏头痛发作期间发生,伴有呕吐或呕吐动作。呕吐或呕吐动作总是先于TGA发作。

结论

偏头痛发作期间发生TGA很罕见。由于在发作起始时经常会出现诸如用力呕吐等瓦尔萨尔瓦动作,通过上腔静脉阻断静脉回流可能会使高静脉压从手臂短暂逆行传导至脑静脉系统,导致间脑或内侧颞叶静脉缺血并引起TGA。

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