眼肌麻痹偏头痛16例临床分析

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.

Clinical Analysis of Eye Muscle Paralysis Migraine

Eye muscle paralysis migraine is rare seen in clinics and its diagnostic standards are in accordance with international headache association classifying criteria in 1990. 16 patients were treated from April 1988 to August 1993 in our hospital and among them 9 were male and 7 were female with their age ranged from 36-60 (average was 51.2). The shortest course was 3 days and the longest was 20 years. 10 cases were acute onset and the other were sub-acute onset with 4 cases of headache history. All data showed that there were many factors that could provoke attacks of this disease such as carotid aneurysm, diabetes, myasthenia gravis, brain tumors, encephalitis and multiple cirrhosis disease according to its aching location and property, characteristics of paralysis, supplementary inspection and prognosis. Therefore, the define diagnosis of migraine headache should be obtained only when other disease were excluded carefully. It must comply with the feature of migraine headache and excluding other organic disease that might cause eye muscle paralysis. The mechanism of eye muscle paralysis migraine may be due to the vasoconstriction in head esp. carotid vasoconstriction that may cause local edema due to local ischemia, then malfunction of carotid area and finally neurogenic ischemia and pathological change occurred. Migraine headache are common in puberty, but according to investigation and analysis around 50 people were still the second most likely to be subject to migraine headache. 10 of 16 cases in this report were old man proved that it may not rare occur in elder.