Queiroz L P, Rapoport A M, Weeks R E, Sheftell F D, Siegel S E, Baskin S M
University Hospital, UFSC, Florianopolis, SC, Brazil.
Headache. 1997 Mar;37(3):137-41. doi: 10.1046/j.1526-4610.1997.3703137.x.
Visual auras (VAs) of 100 patients with migraine with aura were studied by questionnaire. Visual auras accompanied the patients' first headache (HA) in 39% of patients. Only 19% had VAs with every attack. Patients with VAs over the entire HA history had a high frequency (greater than 50%) of attacks with VA; patients with VA during only part of the HA history had a low frequency (less than 50%) of attacks with VA. The auras occurred exclusively prior to the HA in 57%. The free interval between the end of the VA and the start of the HA was usually (75%) shorter than 30 minutes. Most (59%) patients had VAs that lasted from 1 to 30 minutes. They started in the periphery of the visual fields in 56%. The most common phenomena described were: small bright dots (42%), flashes of light (39%), "blind spots" (32%), and "foggy vision" (27%). Fortification spectra was reported by only 20%. Although most (65%) patients had a combination of phenomena, the majority (72%) had only one uniform constellation of manifestations. There was no clear-cut relationship between side of VA and side of HA. Migraine VA is a pleomorphic and complex symptom. Many patients not qualifying for the diagnostic criteria of migraine with aura, as proposed by the International Headache Society (IHS), unequivocally present with visual phenomena that strongly suggest this diagnosis.
通过问卷调查对100例有先兆偏头痛患者的视觉先兆（VAs）进行了研究。39%的患者视觉先兆伴随首次头痛（HA）出现。只有19%的患者每次发作都有视觉先兆。在整个头痛病史中都有视觉先兆的患者，出现伴有视觉先兆发作的频率较高（超过50%）；仅在部分头痛病史中有视觉先兆的患者，出现伴有视觉先兆发作的频率较低（低于50%）。57%的患者先兆仅在头痛之前出现。视觉先兆结束与头痛开始之间的间隔时间通常（75%）短于30分钟。大多数（59%）患者的视觉先兆持续1至30分钟。56%的患者视觉先兆从视野周边开始。最常描述的现象为：小亮点（42%）、闪光（39%）、“盲点”（32%）和“视物模糊”（27%）。仅20%的患者报告有堡垒样光谱。虽然大多数（65%）患者有多种现象组合，但大多数（72%）患者只有一种统一的表现形式。视觉先兆的一侧与头痛的一侧之间没有明确的关系。偏头痛性视觉先兆是一种多形性且复杂的症状。许多不符合国际头痛协会（IHS）提出的有先兆偏头痛诊断标准的患者，明确表现出强烈提示该诊断的视觉现象。
