NEUROLOGY ：偏头痛在先兆期已经出现头痛症状

偏头痛先兆常被看作是偏头痛的头痛发作前的一个特定时期。美国加州大学神经科头痛研究与治疗计划的Jakob M. Hansen博士等人通过研究发现：很多偏头痛发作的头痛症状在先兆期中已经出现。相关论文发表在Neurology杂志2012年10月31日在线版上。

研究人员前瞻性收集头痛和其他症状相对先兆的时程，并将其作为临床试验的一部分。从16个中心纳入267位患者，要求他们进行头痛饮食1个月（I期）。要求他们在先兆出现后马上记录头痛症状，大部分在先兆发作后1小时内。I期中，201位患者中共记录了456次发作。这些患者被随机纳入II期研究。II期中，164位患者共发作405次。总共从201位患者中记录了861次偏头痛发作。

结果发现：大部分的先兆发作（73%）都伴有头痛发作。其他偏头痛症状也经常在先兆期有报道：恶心（51%）、恐光（88%）和恐声（73%）。在先兆症状出现后的早期15分钟内，54%%的患者出现符合偏头痛标准的头痛发作。

研究人员得出结论：头痛和相关的偏头痛症状出现早，大部分患者出现在偏头痛发作的先兆期。

Migraine headache is present in the aura phase

A prospective study

Objectives

Migraine aura is commonly considered to be a distinct phase of a migraine attack that precedes headache. The objective of the study was to examine a large number of prospectively recorded attacks of migraine with aura and determine the timing of headache and other migraine symptoms relative to aura.

Methods

As part of a clinical trial we collected prospective data on the time course of headache and other symptoms relative to the aura. Patients (n = 267) were enrolled from 16 centers, and asked to keep a headache diary for 1 month (phase I). They were asked to record headache symptoms as soon as possible after aura began and always within 1 hour of aura onset. A total of 456 attacks were reported during phase I by 201 patients. These patients were then randomized and included in phase II, during which a total of 405 attacks were reported in 164 patients. In total, we present data from 861 attacks of migraine with aura from 201 patients.

Results

During the aura phase, the majority of attacks (73%) were associated with headache. Other migraine symptoms were also frequently reported during the aura: nausea (51%), photophobia (88%), and photophobia (73%). During the first 15 minutes within the onset of aura, 54% of patients reported headache fulfilling the criteria for migraine.

Conclusion

Our results indicate that headaches as well as associated migraine symptoms are present early, during the aura phase of the migraine attack in the majority of patients.