眼肌麻痹偏头痛16例临床分析

来源 :伤残医学杂志 | 被引量 : 0次 | 上传用户:youshouyao
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眼肌麻痹性偏头痛又称眼肌瘫痪性偏头痛,临床上不多见,诊断标准:全部病例参考1988年国际头痛学会头痛分类标准进行诊断.我院1988年4月~1993年8月收治16例病人,男性9例,女性7例,年龄36岁~60岁(平均年龄51.2岁),病程最短3天,最长20年,突然起病10例,亚急性起病6例,有偏头病史4例。根据本组资料表明:疼痛部位及性质、眼肌麻痹特点、眼肌麻痹伴随疾病、辅助检查、转归与预后,可以看出临床上引起眼肌麻痹原因很多,如颈内动脉瘤、糖尿病、重症肌无力、某些颅内肿瘤、脑炎及多发性硬化症等,因此确诊为眼肌麻痹性偏头痛要细致地排除其它疾病.必须符合以下两点:①有偏头痛特点;②排除引起眼肌麻痹其它器质性疾病。眼肌麻痹性偏头痛发病机制是由于颅内血管收缩尤其是颈内动脉血管收缩造成局部缺血所致局部组织水肿,引起沿颈内动脉分布眼神经功能障碍,导致神经性缺血病变。偏头痛发病年龄一般年轻人多见,但据调查分析发现50岁左右仍为第二高峰年龄组,证明老年人偏头痛也并不少见,本组16例中10例为老年人。 Ophthalmoplegia migraine, also known as oculomotor paralytic migraine, clinically rare, diagnostic criteria: all cases refer to the 1988 International Headache Society headache classification criteria for diagnosis. Our hospital from April 1988 to August 1993 treated 16 patients, 9 males and 7 females, aged 36 to 60 years (mean age 51.2 years), the shortest duration of 3 days, up to 20 years, all of a sudden 10 cases of onset, subacute onset in 6 cases, a history of partial headache in 4 cases. According to this group of data shows: the location and nature of pain, ophthalmoplegia characteristics, accompanying with ophthalmoplegia, auxiliary examination, prognosis and prognosis, we can see that many causes of ophthalmoplegia clinically, such as carotid aneurysm, diabetes, Myasthenia gravis, some intracranial tumors, encephalitis and multiple sclerosis, etc. Therefore, the diagnosis of ophthalmoplegia migraine should be carefully excluded from other diseases. Must meet the following two points: ① have migraine characteristics; ② exclude other organic diseases caused by ophthalmoplegia. The pathogenesis of ophthalmoplegia migraine is due to intracranial vasoconstriction, especially caused by ischemic internal carotid artery contraction caused by local tissue edema, causing the distribution along the internal carotid artery dysfunction, leading to neurological ischemic lesions. Migraine onset age is more common in young people, but according to the survey found that 50 years old is still the second peak age group, proof of migraine elder is not uncommon, the group of 16 cases, 10 cases of the elderly.
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