Karpova M I, Zariada A A, Dolgushina V F, Korotkova D G, Ekusheva E V, Osipova V V
South Ural State Medical University, Russian Ministry of Health, Chelyabinsk.
Academy of Postgraduate Education under FSBU FSCC of FMBA of Russia, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2019;119(3):98-107. doi: 10.17116/jnevro201911903198.
Migraine is one of the most common neurological disorders, affecting women. Physiological changes in the hormonal status can modulate the functional status of pain and analgesic systems of the brain and, by involving different pathophysiological mechanisms, change the course of migraine. In addition to an analysis of epidemiological data, the review provides current views on the clinical features of the disease in women population at different periods of life, particular attention was focused on menstrual migraine. It has certain features, such as acute and long attacks and treatment difficulties. One of main issues is the use of oral contraceptives in women with migraine according to the ratio of potential benefit to cardiovascular risk. The problems of treatment headaches in pregnant and breastfeeding women are also considered. An influence of migraine on the course and outcome of pregnancy was shown. The authors analysed the results of the studies on the course of migraine during perimenopause and postmenopause and recommendations for women with migraine attacks and climacteric syndrome. The data presented in the review are useful for clinicians, because this information represents new views on pathogenetic mechanisms, clinical features and treatment of migraine in women.
偏头痛是最常见的神经系统疾病之一,多见于女性。激素状态的生理变化可调节大脑疼痛和镇痛系统的功能状态,并通过涉及不同的病理生理机制,改变偏头痛的病程。除了对流行病学数据进行分析外,本综述还提供了关于不同生命阶段女性人群中该疾病临床特征的当前观点,特别关注月经性偏头痛。它具有某些特征,如发作急性且持续时间长以及治疗困难。主要问题之一是根据潜在益处与心血管风险的比例,为偏头痛女性使用口服避孕药。还考虑了孕妇和哺乳期妇女治疗头痛的问题。研究表明偏头痛对妊娠过程和结局有影响。作者分析了围绝经期和绝经后期偏头痛病程的研究结果,以及针对有偏头痛发作和更年期综合征女性的建议。本综述中呈现的数据对临床医生很有用,因为这些信息代表了关于女性偏头痛发病机制、临床特征和治疗的新观点。