偏头痛经颅多普勒超声与瞬目反射检查

TRANSCRANIAL DOPPLER AND BLINK REFLEX IN MIGRAINEURS

目的探讨偏头痛血管舒缩功能障碍和神经功能障碍的关系。方法对42例偏头痛发作期和32例间歇期患者进行经颅多普勒超声(TCD)和瞬目反射(BR)检测。结果偏头痛发作期和间歇期大脑中动脉(MCA),大脑前动脉(ACA),大脑后动脉(PCA)及椎基底动脉(VA、BA)的平均血流速度(Vm)明显高于正常对照组(P<0.01),发作期的ACA、BA、VA的Vm明显高于间歇期(P<0.05);两期Vm异常率比较具有显著差异(P<0.05)。BR检测提示脑干功能障碍和三叉神经传入通路、面神经传出通路功能障碍,发作期34例(81%),间歇期24例(75%),两期异常率比较无显著差异(P>0.05)。结论偏头痛患者存在着脑干和以三叉神经为主的神经功能障碍,这很可能是造成血管舒缩功能障碍引起偏头痛发作的原因。

Objective:To find out the relationship between functional disorder of blood vessel contraction relaxation and neurologic impairment in migrain patients. Methods: Forty two migraineurs during attack and 32 migraineurs in rest phase were accessed with transcranial doppler (TCD) and blink reflex (BR) assay. Results: The average flow velocity (Vm) of middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), vertibral artery (VA) and basilar artery (BA) in migraineurs were much higher than in controls( P <0.01). The Vm of ACA,BA,VA were also higher in attack phase than in rest phase. The abnormal rates of Vm in migraineurs are different between two phases ( P <0.05). The BR results suggested the functional disorder of brainstem, afferent pathway of Trigeminal Nerves and efferent pathway of Facial Nerve in 34(81%) cases during attack and 24 (75%) cases during interval period. There were no significant differences of abnormal proportion between two phases ( P >0.05). Conclusion: In migraineurs there is functional brainstem disorder and neurologic impairment mainly in trigeminal nerves, which might be the cause of functional disturbance of blood vessel contraction and relaxation.