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目的观察间歇期偏头痛脑血管功能障碍及脑干功能改变。方法对临床确诊的偏头痛患者首先进行经颅多谱勒超声(TCD)筛选,对TCD异常者进行脑干听觉诱发电位(BAEP)及瞬目反射(BR)检查。并以同期50例健康志愿者作为对照。结果偏头痛间歇期存在颅内血管流速的异常改变。30例TCD异常的偏头痛中,BAEP异常12例,占40%。主要表现为Ⅲ波、Ⅴ波潜伏期延长,波幅降低或Ⅰ～Ⅲ波、Ⅲ～Ⅴ波波间期异常,均提示脑干病变。BR异常22例,占73.3%。其中R2、R2,均异常15例,提示三叉神经传入通路功能障碍。结论偏头痛的TCD改变反映了颅内血管舒缩功能异常,BAEP和BR改变提示脑干功能损害。两者可能互为因果、相互影响。
Objective To observe the intermittent migraine headache cerebrovascular dysfunction and brain stem function changes. Methods Transcranial Doppler ultrasonography (TCD) screening was performed on clinically diagnosed migraineurs and brainstem auditory evoked potentials (BAEP) and blink reflex (BR) were examined in patients with abnormal TCD. Fifty healthy volunteers were used as control. Results There was an abnormal change of intracranial blood flow velocity during the intermittent migraine. In 30 cases of TCD abnormal migraine, BAEP was abnormal in 12 cases (40%). Mainly for Ⅲ wave, Ⅴ wave latency prolongation, reduced amplitude or Ⅰ ~ Ⅲ wave, Ⅲ ~ Ⅴ inter-wave anomalies, are prompted brain stem lesions. BR abnormalities in 22 cases, accounting for 73.3%. Of which R2, R2, were abnormal in 15 cases, suggesting that the trigeminal nerve afferent pathway dysfunction. Conclusion The TCD changes of migraine reflect the dysfunction of intracranial vasomotor function. The changes of BAEP and BR indicate the impairment of brainstem function. The two may each cause and effect, influence each other.