论文部分内容阅读
目的:研究原发性阵发性偏侧头痛(paroxysmal hemicrania,PH)的临床特征,并对国际头痛疾病分类第三版试行版(International Classification of Headache Disorders,3rd Edition,beta version,ICHD-Ⅲbeta)中阵发性偏侧头痛的诊断标准进行临床实践测试。方法:参照ICHD-Ⅲbeta诊断标准,3648例以头痛为主诉的头痛门诊患者中,10例诊断为PH,对其人口学特征以及临床特征进行分析。结果:PH起病年龄为(40.40±12.77)岁,男性5例(50%),女性5例(50%)。10例患者亚型全为发作性阵发性偏侧头痛(100%),头痛发作部位最常见于颞部(80%)和眼眶(50%),最常见的自主神经症状症状为同侧眼部充血、流泪、水肿(70%);患者均为中重度疼痛,以跳痛最为常见。头痛发作持续时间基本在2~30 min以内,但有40%的患者曾出现不满足PH诊断标准中的B标准的情况。发作期一半以上的天数头痛发作频率均在5次/d以上。对吲哚美辛治疗的反应良好。结论:头痛门诊中PH患者的临床特征与国外的报道相似,但以EPH的发病率较高,与国外CPH为主的发病特征有差异。PH的诊断标准(ICHD-Ⅲbeta)基本符合临床运用实践,新增的两个可能伴随症状均有临床意义。但仍需进一步改进,如头痛发作时长的规定。
OBJECTIVE: To study the clinical features of paroxysmal hemicrania (PH) and to evaluate the clinical features of International Classification of Headache Disorders (3rd Edition, beta version, ICHD-Ⅲbeta) In paroxysmal hemifacial headache diagnostic criteria for clinical practice test. Methods: According to the diagnostic criteria of ICHD-Ⅲbeta, 10 out of 3648 headache patients with headache who complained of headache were diagnosed as PH, their demographic characteristics and clinical features were analyzed. Results: The age of onset of PH was (40.40 ± 12.77) years. There were 5 males (50%) and 5 females (50%). The 10 subtypes were all paroxysmal paroxysmal headaches (100%), the most common headache attack sites were in the temporal (80%) and orbit (50%). The most common symptoms of autonomic symptoms were ipsilateral Ministry of congestion, tearing, edema (70%); patients were moderate to severe pain, the most common to jump pain. The duration of the headache attack was basically within 2 to 30 minutes, but 40% of the patients did not meet the B criteria in the PH diagnostic criteria. More than half the number of attacks in the first few days were more than 5 times / d. Indomethacin treatment responded well. Conclusion: The clinical features of PH patients in headache clinic are similar to those in foreign countries. However, the incidence of EPH is higher than that of foreign CPH. PH diagnostic criteria (ICHD-IIIbeta) basically in line with clinical practice, the new two may have clinical significance associated with the symptoms. But still need to be further improved, such as the duration of the headache.