癫癎发作后头痛的临床特征及其危险因素  

Clinical features of post-ictal headache in patients with epilepsy and the risk factors

作　　者：汪银洲[1] 余峰[1] 章军建[2] 许文华[1] 丁小灵[1] 杨毅[1] 

机构地区：[1]安徽省立医院神经内科,合肥230001 [2]武汉大学中南医院神经内科,430071

出　　处：《中国实用内科杂志》2002年第10期590-592,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的　为研究癫疒间 发作后头痛 (post ictalheadaches,PIH)的临床特征及其发生的危险因素。 方法　采用病史询问方法对 97例与部位有关的癫疒间患者头痛的临床特征进行研究。结果　发现PIH一般表现为搏动性头痛 ,咳嗽、呕吐、弯腰、喷嚏、突然头部运动等能使头痛加重 ,部分患者伴有恶心、呕吐、畏光、怕声等症状 ,睡眠能使部分患者头痛减轻和缓解。PIH的发生率为 3 6 1% ,致疒间 灶的部位不同其PIH发生率也不同 ,颞叶癫疒间PIH的发生率为 2 1 3 % ,枕叶癫疒间为 61 9% ,额叶癫疒间 为 41 4% ,枕叶明显高于颞叶和额叶 (P <0 0 5 ) ,另外强直 -阵挛性发作患者PIH发生率高于其它类型发作 ,发病年龄越轻的患者PIH发生率越高。结论　PIH与偏头痛具有某些共同临床特点。Objective To determine the clinical characteristics of post ictal headache (PIH) and clinical risk factors associated with the occurrence of PIH in patients with localization related epilepsy.Methods The subjects were 47 patients with temporal lobe epilepsy (TLE),21 patients with occipital lobe epilepsy (OLE),and 29 patients with frontal lobe epilepsy (FLE).The subjects were directly asked whether headaches occurred just after seizures and its characteristics.Results The characteristics of PIH were:throbbing quality,which was exacerbated by coughing,vomiting,bending,and sudden head movement,accompanied by photophobia,phonophobia,and relieved by sleep.The incidence of PIH was 21 3% for TLE,61 9% for OLE,and 41 4% for FLE.The risk of PIH was significantly higher for OLE than for TLE or FLE,and for patients with generalized tonic clonic seizures.Younger onset age of epilepsy was also a risk factor for PIH.Conclusions PIH possess some characteristics similar to migraine.The occurrence of PIH may be related to the region of epileptic focus and the region of the spread of epileptic discharges.

关 键 词：癫痫发作 头痛 临床特征 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]