The premonitory symptoms (prodrome): A tertiary care study of 893 migraineurs
The premonitory symptoms (prodrome): A tertiary care study of 893 migraineurs
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DOI：
10.1111/j.1526-4610.2004.04168.x
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发表时间：
2004-10-01
期刊：
影响因子：
5
通讯作者：
Kelman, L
中科院分区：
文献类型：
--
作者：
Kelman, L
目标。本研究对偏头痛的先兆症状进行了研究，以记录一大群偏头痛患者的频率、持续时间和症状类型。前驱症状的重要性仍在争论中。在偏头痛发作的早期干预是假设更重要的，需要更好地了解前驱体。共有893名偏头痛患者（IHS 1.1-1.7）在首次就诊时进行了评估。分析了总偏头痛人群IHS 1.1-1.7和IHS 1.1-1.6偏头痛的前驱症状频率、持续时间和特征。IHS偏头痛1.1-1.6患者中共有32.9%报告前驱症状，平均9.42小时。IHS 1.1-1.7偏头痛分别报告了29.7%和6.8小时。最常见的症状是疲倦、情绪变化和胃肠道症状; 17%的前驱症状患者同时出现这三种症状。前驱症状持续时间<1 h者占45.1%，12 h者占13.6%，2-4 h者占15.0%，4-12 h者占13.1%，> 12 h者占13.2%。IHS1.1 -1.7组患者也有类似的结果，IHS1.1 -1.6组有前驱症状的患者与无前驱症状的患者相比，总体上有更多的触发因素（P < .01），更多的个人触发因素，包括酒精（P < .01），激素（P < .01），轻度（P <0.001）不吃（P < .05），香水（P < .01），应激（P < .01），天气变化（P < .05），先兆持续时间较长（P < .05），先兆与头痛间隔时间较长（P < .05），无头痛的先兆更多头痛达峰时间延长（P < .05）（P < .05），曲坦起效时间较长（P < .05），头痛的最大持续时间较长（P < .05），头痛伴恶心者多（P <0.05），头痛伴流鼻涕或流泪者多（P <0.05），后期综合征多（P <0.05），后期综合征持续时间长（P <0.001）。这项研究提供了一个大的患者队列前驱症状的画像。它突出了前驱症状患者和无前驱症状患者之间的差异，并引起了人们对预防急性偏头痛发作的头痛阶段的潜力的关注。
Objectives.-This study of premonitory symptoms in migraine was performed to document the frequency, duration, and types of symptoms in a large group of migraine patients.Background.-Prodrome importance continues to be debated. Intervention early in the migraine attack is assuming more importance and necessitates better knowledge of the prodrome.Methods.-A total of 893 migraine patients (IHS 1.1-1.7) were evaluated at first visit. Prodrome frequency, duration, and characteristics were analyzed in the total migraine population IHS 1.1-1.7 and IHS 1.1-1.6 migraine.Results.-A total of 32.9% of IHS migraine 1.1-1.6 patients reported prodrome symptoms with an average of 9.42 hours. IHS 1.1-1.7 migraine reported 29.7% and 6.8 hours, respectively. The most commonest symptoms were tiredness, mood change, and gastrointestinal symptoms; all three of these symptoms were present together in 17% of the patients with prodrome. The duration of prodrome was less than 1 hour in 45.1%, 1-2 hours in 13.6%, 2-4 hours in 15.0%, 4-12 hours in 13.1%, and greater than 12 hours in 13.2%. IHS 1.1-1.7 patients showed similar findings.IHS 1.1-1.6 patients with prodrome differed from patients without prodrome in having more triggers as a whole (P < .01), more individual triggers including alcohol (P < .01), hormones (P < .01), light (P < .001), not eating (P < .05), perfume (P < .01), stress (P < .01), and weather changes (P < .05), a longer duration of aura (P < .05), longer time between aura and headache (P < .05), more aura with no headache (P < .05), longer time to peak of headache (P < .05), longer time to respond to triptan (P < .05), longer maximum duration of headache (P < .05), and more headache associated nausea (P < .05), more headache associated running of the nose or tearing of the eyes (P < .05), more postdrome syndrome (P < .05), and longer duration of postdrome syndrome (P < .001).Conclusions.-This study provides a portrait of prodrome in a large cohort of patients. It highlights differences between patients with prodrome and patients not having prodrome, and it draws attention to the potential of preventing the headache phase of the acute migraine attack.