Migraine-偏头痛(中英双语版)复习进程.ppt

1) Cluster headache (丛集性头痛） men women ;(4～5：1） 20-50 yr.; recurrent; several or many times daily for several days or weekes; Prodromes先兆 are uncommon, Ictal发作 and stop suddenly; periorbital strong pain with congestion of the conjunctivae,lacrimation流泪, occasional ptosis上睑下垂 of the eyelids and sweating; A.Cause and pathogenesis The real causes and the pathogenesis and pathophysiologic course of migraine is unknown. 1.Certain foods: tyramine酪胺-containing cheeses,meat,such as hot dogs or bacon,with nitrite亚硝酸preservatives, chocolate containing but not chocolate alone. Food additives: monosodium glutamate谷氨酸一钠； Fasting禁食; Emotion情绪; Menses月经; Drugs:especially oral contraceptive agents; vasodilators (nitriglycerin硝酸甘油) Brights lights may also trigger or precipitate attacks. 2. Genetics: About 60% patients of migraine have families . Three genetic loci for familial hemiplegic migraine（偏瘫型)have been identified 3. Endocrine factor 内分泌异常 Gender: women men (2/3 to 3/4 of cases occur in women); Headache mostly occurs before or menacme月经期 in women , and the headache becomes reduction or stopping in pregnancy and after menopause绝经. The migraine also stops in men of after climacterium更年期. 4. vasomotor and autonomic 血管运动和自律神经 Intracranial vasoconstriction and extracranial vasodilatation have long been held to be the respective causes of the aura and headache phases of migraine. But the study of CBF脑血流 can’t confirm. 5. spreading depression 扩布性抑制 More recent studies of rCBF局部脑血流 during migraine attacks have demonstrated a reduction in regional flow, which begins in the occipital region and then towards with 1 cm/s velocity during the aura phase. 6. Neurotransmitter（神经递质） Serotonin血清素 in platelets decreases and urinary serotonin increases during the acute phase of a