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颈痛是否与偏头痛患者更严重的临床表现相关?一项横断面研究。

Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study.

机构信息

Department of Health of Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.

Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.

出版信息

Cephalalgia. 2019 Oct;39(12):1500-1508. doi: 10.1177/0333102419854061. Epub 2019 May 27.

Abstract

OBJECTIVE

To investigate the association between the presence of self-reported neck pain in patients with migraine and clinical features, upper cervical mobility, and neck muscle performance.

METHODS

A total of 142 patients with migraine were recruited and stratified by the presence (n = 99) or absence of self-reported neck pain (n = 43). The clinical examination included the Migraine Disability Assessment, the 12-item Allodynia Symptom Checklist, a flexion rotation test, and the Craniocervical Flexion Test.

RESULTS

Migraine-related disability was reported by more than 80% in both groups ( = 0.82). However, there was a greater prevalence and severity of cutaneous allodynia observed in the group with neck pain ( < 0.001). Reduced upper cervical mobility was verified in 67% of the patients with neck pain and in 41% of those without neck pain ( = 0.005). In addition, 67% of the patients with neck pain and 40% without neck pain were not able to maintain the third stage of the Craniocervical Flexion Test without compensation ( = 0.003).

CONCLUSIONS

The presence of self-reported neck pain in patients with migraine was associated with a poor clinical presentation regarding cutaneous allodynia, neck mobility, and muscle function. However, there were no differences in migraine-related disability.

摘要

目的

探讨偏头痛患者自述颈部疼痛与临床特征、上颈椎活动度和颈部肌肉功能之间的关系。

方法

共招募了 142 名偏头痛患者,并根据是否存在(n=99)或不存在(n=43)自述颈部疼痛进行分层。临床检查包括偏头痛残疾评估、12 项感觉异常症状检查表、屈伸旋转试验和颅颈屈伸试验。

结果

两组患者的偏头痛相关残疾报告率均超过 80%( = 0.82)。然而,颈部疼痛组的皮肤感觉异常的患病率和严重程度更高( < 0.001)。颈部疼痛患者中有 67%存在上颈椎活动度受限,而无颈部疼痛的患者中仅有 41%存在( = 0.005)。此外,有 67%的颈部疼痛患者和 40%的无颈部疼痛患者无法在没有代偿的情况下完成颅颈屈伸试验的第三阶段( = 0.003)。

结论

偏头痛患者自述颈部疼痛与皮肤感觉异常、颈部活动度和肌肉功能的不良临床表现相关,但与偏头痛相关残疾无差异。

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