1 Headache Center, Hospital da Luz, Lisboa, Portugal.
2 Headache Outpatient Clinic, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Lisboa, Portugal.
Cephalalgia. 2018 Jun;38(7):1335-1350. doi: 10.1177/0333102417728250. Epub 2017 Aug 28.
Introduction Cognitive symptoms have been described during migraine attacks since the Roman era; while being neglected throughout the centuries, they are relevant contributors to migraine-related disability. Objective To determine whether cognitive symptoms are included in clinical series describing migraine attack phenomenology, and which symptoms occur in each attack phase. Method Systematic review of existing data on clinical descriptions of migraine attacks, focusing on cognitive symptomatology. Data were organized and analyzed qualitatively, due to methodological differences between studies. Results Twenty-four articles were reviewed, with a total sample of 7007 patients, including 82.9% females with an average age of 39.2 years. Twenty one (75%) studies analyzed one phase of the attack (eight prodromes, five auras, one between aura and pain, three headaches and three postdromes), the remaining studied more than one phase. Cognitive complaints were the most frequent symptom of the prodromic (30%) and headache (38%) phases, while fatigue (70%) dominated the resolution phase. Not enough data is available to estimate the frequency of cognitive symptoms during the aura. Discussion Cognitive symptoms are described in all phases of the migraine attack phenomenology in published clinical series of migraine. Their characteristics appear to be different in each attack phase, although methodological limitations prevent generalization of this finding.
介绍 自罗马时代以来，人们就已经描述了偏头痛发作期间的认知症状；尽管这些症状在几个世纪以来一直被忽视，但它们是导致偏头痛相关残疾的重要因素。目的 确定认知症状是否包含在描述偏头痛发作现象学的临床系列中，以及每个发作阶段会出现哪些症状。方法 对现有的关于偏头痛发作的临床描述的相关数据进行系统回顾，重点关注认知症状。由于研究之间存在方法学差异，因此对数据进行了定性组织和分析。结果 共回顾了 24 篇文章，其中包括 7007 例患者，其中 82.9%为女性，平均年龄为 39.2 岁。有 21 项研究（75%）分析了一个发作阶段（8 个前驱期、5 个先兆期、1 个先兆与头痛之间、3 个头痛期和 3 个后效期），其余研究分析了多个阶段。认知主诉是前驱期（30%）和头痛期（38%）最常见的症状，而疲劳（70%）主导着缓解期。目前还没有足够的数据来估计先兆期内认知症状的频率。讨论 在偏头痛的发表的临床系列中，认知症状被描述为偏头痛发作现象学的所有阶段。尽管由于方法学限制，无法推广这一发现，但它们在每个发作阶段的特征似乎有所不同。
