(Headic and Facial Paint)12有预兆的偏头痛-阳明大学.ppt

Headache and Facial Pain 偏頭痛之求醫行為 一年內有 54﹪求診過醫師。 10.4﹪一年內求診醫師超過十次以上。 偏頭痛之求醫行為 求診醫師的順序 家庭醫師（29.3﹪） 內科（17.4﹪） 耳鼻喉科醫師（14.3﹪） 神經科醫師（12.2﹪） 婦產科醫師（4.9﹪） 眼科（4.6﹪） 4.3﹪的病人求救過急診 偏頭痛之求醫行為 藥物來源 藥房 61﹪ 醫師處方 23﹪ 7.5﹪病人一個月大於十次以上 2.5﹪每天吃止痛藥。 正確的診斷 國際頭痛學會頒訂頭痛分類診斷標準 第一版 1988 年出版 中文版洪祖培等翻譯，1993年 第二版 ︰2004 年 （已在2003 年九月於羅馬出版） International Headache Society Primary vs. secondary headache The International Classification of Headache Disorders 2nd edition (ICHD-II), 2004  Part one: Primary headaches 1. Migraine 2. Tension-type headache 3. Cluster headache and other trigeminal autonomic cephalalgias 4. Other primary headache Part two: The secondary headache 5. Headache attributed to head and /or neck trauma 6. Headache attributed to cranial or cervical vascular disorders 7. Headache attributed to non-vascular intracranial disorder 8. Headache attributed to a substance or its withdrawal 9. Headache associated with noncephalic infection 10. Headache attributed to disorder of homoeostasis 11. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures 12. Headache attributed to psychiatric disorder Part three: Cranial neuralgias, central and primary facial pain and other headaches 13. Cranial neuralgias and central causes of facial pain 14. Other headache, cranial neuralgia, central or primary facial pain 國際頭痛學會偏頭痛分類 1.1無預兆的偏頭痛(migraine without aura) 1.2有預兆的偏頭痛(migraine with aura) 1.3可能為偏頭痛前驅或相關症狀之孩童週期 性症候群 1.4視網膜偏頭痛(retinal migraine) 1.5偏頭痛之併發症(complications of ? ? ? migraine) ? 1.6 可能偏頭痛(probable migraine) 國際頭痛學會偏頭痛分類 無預兆偏頭痛 (ICHD-II code 1.1) (migraine without aura)- common migraine 有預兆偏頭痛 (ICHD-II code 1.2) (migraine with aura)- classical migraine 10:1 to 3: 1 Headache profiles for migraine “Migraine, the Sick-headache” Moderate to severe headache, Onset between 10-30 y/o, female predominant (3:1) Un