Higgins Nicholas, Pickard John, Lever Andrew
Addenbrooke's Hospital, Cambridge CB2 0QQ.
J Obs Pain Med. 2013 Apr;1(2):28-35.
Headache is common in chronic fatigue syndrome, a condition of unknown cause in which there are no clinical signs. Fatigue is common in idiopathic intracranial hypertension, a headache condition of unknown cause in which the only clinical signs are those of raised intracranial pressure, signs which may be absent. Might, therefore, idiopathic intracranial hypertension be present in some patients diagnosed with chronic fatigue syndrome? Could the two conditions be related?
From June 2007, patients attending a specialist clinic who fulfilled the diagnostic criteria for chronic fatigue syndrome and in whom headache was an especially prominent symptom were offered CT venography and lumbar puncture, looking for evidence of raised intracranial pressure.
Of the 20 patients who accepted lumbar puncture, eight had pressures of 20 cm HO or greater, including three who had pressures of 25 cm HO or greater. Mean pressure was 19 cm HO.
Some patients with headache and a diagnosis of chronic fatigue syndrome have unrecognised and occult idiopathic intracranial hypertension. The possibility that the two conditions are related cannot be excluded.
头痛在慢性疲劳综合征中很常见,这是一种病因不明且无临床体征的病症。疲劳在特发性颅内高压中很常见,这是一种病因不明的头痛病症,其唯一的临床体征是颅内压升高的体征,而这些体征可能并不存在。那么,在一些被诊断为慢性疲劳综合征的患者中是否存在特发性颅内高压?这两种病症是否有关联?
从2007年6月起,对到专科门诊就诊、符合慢性疲劳综合征诊断标准且头痛为突出症状的患者进行CT静脉造影和腰椎穿刺,以寻找颅内压升高的证据。
在接受腰椎穿刺的20例患者中,8例颅内压为20cm H₂O或更高,其中3例颅内压为25cm H₂O或更高。平均颅内压为19cm H₂O。
一些诊断为慢性疲劳综合征且有头痛症状的患者存在未被识别的隐匿性特发性颅内高压。不能排除这两种病症有关联的可能性。