特殊类型偏头痛:诊断质疑

SPECIAL TYPE MIGRAINE:DIAGNOSTIC SUSPICION

目的：探讨特殊类型偏头痛诊断的合理性。方法：１１例符合特殊类型偏头痛的病人，进行了ＣＴ、ＭＲＩ、ＤＳＡ或ＴＣＤ检查以查找可能的病因。结果：８例眼肌麻痹型偏头痛有５例确诊为Ｗｉｌｉｓ环动脉瘤，２例为ＴｏｌｏｓａＨｕｎｔ综合征，１例为糖尿病性眼肌麻痹。２例偏瘫型偏头痛被证实为短暂性脑缺血发作（ＴＩＡ）。１例基底动脉型偏头痛也被证实为脉管炎所致的ＴＩＡ。讨论和结论：特殊类型偏头痛为一描述性诊断，随着科学技术的发展，更多地被确诊为其他疾病，结合文献，本文对此诊断存在的合理性提出了质疑，建议在新的国际头痛分类中取消这一诊断。

Abstract Objectve: To analyse and discuss the diagnosis of special type migraine. Methods: 11 cases with suspected special type migraine were observed by CT、MRI、TCD or DSA. Results: The diagnoses in 8 cases with suspected ophthalmoplegia migraine were denied. The final diagnoses were cerebral aneurysm (5 cases)、Tolosa-Hunt Syndrome (2 cases) and diabetic ophthalmoplegia (1 case). 2 cases with suspected hemiplegic migraine and 1 case with suspected basilar atrery migraine were finally diagnosed as TIA(Transient Ischemic Attack). Discussion conclusion and: Special type migraine is a described diagnosis and most patients with this diagnosis were finally diagnosed as other diseases. We suggest that this diagnosis should be cancelled in new international headche criterion.