癫痫共病头痛

Comorbidity of epilepsy and headache

癫痫常常共患其他神经精神疾病,称为癫痫共病。其中,癫痫共病偏头痛十分常见,虽然二者是不同的疾病,但其在病理生理及临床症状方面多有重叠,且多种抗癫痫发作药物(ASMs)被证实对偏头痛有效。但是目前关于癫痫共病偏头痛的概念仍有较多争议,偏头痛常常因漏诊或误诊而难以得到有效治疗。为提高临床医生对癫痫共病偏头痛的识别及精准治疗能力,本文对癫痫共病偏头痛的可能机制进行阐述,并根据头痛症状与癫痫发作的时间关联,结合癫痫共患偏头痛诊断治疗的中国专家共识(2019)及国际头痛协会(IHS)发布的国际头痛疾病分类第3版(ICHD-3-2018)中癫痫合并偏头痛的分类及诊断标准,对癫痫共病偏头痛概念、鉴别及诊疗计划进行梳理。

Epilepsy is often comorbid with other neuropsychiatric conditions,which are known as epilepsy comorbidities.Among these conditions,the comorbidity of epilepsy and migraine is very common.Although they are two different diseases,they overlap in terms of pathophysiological features and clinical symptoms,and several anti-seizure medications(ASMs)have been proved to be effective in migraine.However,there are still controversies over the concept of epilepsy comorbid with migraine,and there is often a lack of effective treatment for migraine due to missed diagnosis or misdiagnosis.In order to improve the ability for identification and precise treatment of epilepsy comorbid with migraine among clinicians,this article elaborates on the possible mechanism of epilepsy comorbid with migraine and discusses the concept,identification,and diagnosis and treatment regimens for epilepsy comorbid with migraine by considering the temporal association between headache symptoms and epileptic seizures,with reference to the classification of epilepsy comorbid with migraine and related diagnostic criteria in Chinese expert consensus(2019)and the ICHD-3-2018 guidelines issued by the International Headache Society.