Lanzi G, Balottin U, Borgatti R
Chair of Child Neuropsychiatry, C. Mondino Foundation, University of Pavia, Italy.
Headache. 1994 May;34(5):275-8. doi: 10.1111/j.1526-4610.1994.hed3405275.x.
We studied a group of young migraine with aura patients with whom it was possible to reconstruct the course and the characteristics of the disturbances preceding or accompanying the onset of the headache. The 47 subjects, 31 female and 16 male, were diagnosed (IHS classification) as Migraine with typical aura (n = 40), Familial hemiplegic migraine (n = 1), Basilar migraine (n = 6), and Migraine with prolonged aura (n = 5). Visual (43 cases) and sensory disturbances (20 cases) were the most commonly described symptoms; a motor deficit was reported in 10 out of 47 cases. Other disturbances such as vertigo attacks, aphasia, spatial disorientation, loss of consciousness or a decreased level of consciousness with the appearance of automatic movements, were much rarer. In our cases the visual disturbances were not isolated but were accompanied by other symptoms in 29 cases, and in 5 of the 18 cases in which there were only visual symptoms, the disturbances presented in succession; a "march" of the sensory and motor disturbance was found in 66% and 68% of cases, respectively. The data from our cases in which the disturbance seems most frequently to originate in the occipital areas (visual disorders) and then to spread to the temporo-parietal regions in part confirms that there is a posterior to anterior dynamic in the cerebral areas involved.
我们研究了一组有先兆的年轻偏头痛患者，通过他们能够重构头痛发作之前或伴随头痛发作时的症状过程及特点。47名受试者中，女性31名，男性16名，根据国际头痛协会（IHS）分类，诊断为典型先兆偏头痛（n = 40）、家族性偏瘫性偏头痛（n = 1）、基底型偏头痛（n = 6）以及伴迁延性先兆的偏头痛（n = 5）。视觉症状（43例）和感觉障碍（20例）是最常描述的症状；47例中有10例报告有运动功能缺损。其他症状如眩晕发作、失语、空间定向障碍、意识丧失或伴有自动运动出现的意识水平下降则较为少见。在我们的病例中，视觉障碍并非孤立出现，29例伴有其他症状，在仅出现视觉症状的18例中有5例症状相继出现；分别有66%和68%的病例出现感觉和运动障碍的“进展”。我们病例的数据显示，症状似乎最常起源于枕叶区域（视觉障碍），然后部分扩散至颞顶叶区域，这部分证实了受累脑区存在从后向前的动态变化。
