1 Headache Science Center, C. Mondino National Neurological Institute, Pavia, Italy.
2 Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Cephalalgia. 2017 Sep;37(10):979-989. doi: 10.1177/0333102416657147. Epub 2016 Aug 29.
Background A detailed evaluation of migraine aura symptoms is crucial for classification issues and pathophysiological discussion. Few studies have focused on the detailed clinical aspects of migraine aura. Methods We conducted a prospective diary-based study of migraine aura features including presence, quality, laterality, duration of each aura symptom, their temporal succession; presence of headache and its temporal succession with aura. Results Seventy-two patients completed the study recording the characteristics of three consecutive auras ( n = 216 auras). Visual symptoms occurred in 212 (98%), sensory symptoms in 77 (36%) and dysphasic symptoms in 22 (10%). Most auras had more than one visual symptom (median 2, IQR 1-3, range 1-4). The majority of patients (56%) did not report a stereotyped aura on the three attacks with respect to visual features, the combination and/or temporal succession of the three aura symptoms. Fifty-seven percent of patients also reported a different scenario of temporal succession between aura and headache in the three attacks. Five per cent of aura symptoms were longer than four hours. Conclusion These findings show a high inter- and intravariability of migraine with aura attacks. Furthermore, they provide reliable data to enrich and clarify the spectrum of the aura phenotype.
背景:详细评估偏头痛先兆症状对于分类问题和病理生理学讨论至关重要。很少有研究关注偏头痛先兆的详细临床方面。
方法:我们进行了一项前瞻性基于日记的偏头痛先兆特征研究,包括先兆症状的存在、性质、偏侧性、每种先兆症状的持续时间及其时间顺序;头痛的存在及其与先兆的时间顺序。
结果:72 名患者完成了这项研究,记录了连续 3 次偏头痛先兆的特征(n=216 次先兆)。212 名患者(98%)出现视觉症状,77 名患者(36%)出现感觉症状,22 名患者(10%)出现言语障碍症状。大多数先兆有超过 1 个视觉症状(中位数 2,IQR 1-3,范围 1-4)。大多数患者(56%)在 3 次发作中未报告视觉特征、3 种先兆症状的组合和/或时间顺序具有刻板模式。57%的患者在 3 次发作中还报告了先兆和头痛之间不同的时间顺序。5%的先兆症状持续时间超过 4 小时。
结论:这些发现表明偏头痛先兆发作具有较高的发作内和发作间可变性。此外,它们提供了可靠的数据来丰富和阐明先兆表型谱。
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