Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, Canada.
Curr Neurol Neurosci Rep. 2020 May 19;20(6):17. doi: 10.1007/s11910-020-01037-3.
To provide an updated review of the pathophysiology, diagnosis, and management of migraine with aura.
Thalamic and other subcortical regions may play a role in the pathophysiology of migraine. There is inter-patient and intra-patient attack variability in the characteristics of typical aura especially visual aura symptoms. Migraine with brainstem aura may originate cortically. Migraine with retinal aura may be associated with structural and functional changes in the retina. Although cortical spreading depression (CSD) continues to be the predominant theory surrounding the pathophysiology of migraine with aura, the exact mechanism of action of CSD and its role in relation of all phases of migraine including features of aura are not fully understood. Novel experimental models and newer diagnostic tools including neuroimaging are currently being used to enhance of understanding of migraine with and without aura. Transient ischemia attacks, stroke, and epilepsy should be considered in your differential diagnosis of migraine with aura. There are no specific therapies for migraine with aura.
提供偏头痛伴先兆的病理生理学、诊断和治疗的最新综述。
丘脑和其他皮质下区域可能在偏头痛的病理生理学中起作用。典型先兆，特别是视觉先兆症状，在不同患者和同一患者的发作中存在变异性。脑干先兆偏头痛可能起源于皮质。视网膜先兆偏头痛可能与视网膜的结构和功能变化有关。尽管皮质扩散性抑制（CSD）仍然是偏头痛伴先兆病理生理学的主要理论，但 CSD 的确切作用机制及其在偏头痛所有阶段（包括先兆特征）中的作用尚不完全清楚。目前正在使用新的实验模型和新的诊断工具，包括神经影像学，以增强对有先兆和无先兆偏头痛的理解。在偏头痛伴先兆的鉴别诊断中，应考虑短暂性脑缺血发作、中风和癫痫。目前尚无针对偏头痛伴先兆的特异性治疗方法。
