多发性硬化患者原发性头痛的特征及发病情况

doi:10.6040/j.issn.1671-7554.0.2015.886

摘要/Abstract

摘要： 目的探讨原发性头痛与多发性硬化(MS)间的关系。方法选择171例MS患者,其中头痛组51例,非头痛组120例,分析头痛组原发性头痛的特征及不同类型头痛的发病情况。对比头痛组和非头痛组的病程、发病类型、影像学及相关疾病的发病情况。结果 29.8%的MS患者伴有原发性头痛,2/3患者头痛早于MS症状,头痛以颞侧、枕部好发,搏动性、紧缩性痛常见,持续4 h以上,发作较频繁,多为中、重度疼痛。多有3处以上(90.2%)的发病部位,脑干、丘脑、胼胝体处的病灶明显多于非头痛组。偏头痛(47.1%)最常见,以年轻的复发缓解型多发性硬化(R-R MS)多见。继发进展型多发性硬化(SP MS)好发紧张型头痛,年龄较偏头痛患者更大(P<0.05)。头痛组患者较非头痛组患者更易合并脑梗死(P<0.05)。结论近1/3的MS患者伴有原发性头痛,年轻患者多见,病灶较多,脑干为主,疼痛较严重,偏头痛最常见。

关键词: 多发性硬化, 偏头痛, 脑梗死, 核磁共振

Abstract: Objective To investigate the association between primary headaches and multiple sclerosis(MS). Methods One hundred and seventy-one MS patients were enrolled and divided into two groups, headache group(51 cases)and non headache group(120 cases). MS form, duration, radiology and occurrence of other related diseases in the two groups were retrospectively analyzed and compared. Features and incidence of subtypes of primary headaches in non headache group were also analyzed. Results 29.8% MS patients were accompanied by primary headaches. Two-thirds of patients reported headaches before occurring of MS symptoms. Throbbing and tightening pain were common, mainly appeared in the bitemporal and occiput. Pain often lasted for more than 4 hours, attacked frequently and severely. Most of the patients in headache group showed more than 3 lesion locations(90.2%), which were more common in the brainstem, thalamus and corpus callosum than those of non headache group. Of primary headaches, migraine(47.1%)was the most common type, observed more often in young relapsing-remitting MS(R-R MS)patients. While, secondary progressive MS(SP MS)patients was often accompanied by tension-type headache, who were older than migraine patients(P<0.05). The patients in headache group were more likely combined with cerebral infarction than those in non headache group(P<0.05). Conclusion Nearly one-third of MS patients are accompanied by primary headaches, of which migraine is the most common type. The headaches are often serious. These patients always have more demyelinating lesions than those without headaches, and the lesions mainly locate in the brain stem.

Key words: Migraine primary headaches, Multiple sclerosis, Magnetic resonance imaging

中图分类号:

R742

刁晓君,陈春富,李聪聪,张颖博,李婴婴. 多发性硬化患者原发性头痛的特征及发病情况[J]. 山东大学学报（医学版）, 2016, 54(4): 42-45.

DIAO Xiaojun, CHEN Chunfu, LI Congcong, ZHANG Yingbo, LI Yingying. Characteristics and prevalence of primary headaches in patients with multiple sclerosis[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 42-45.

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