COMORBIDITY OF MIGRAINE AND EPILEPSY
COMORBIDITY OF MIGRAINE AND EPILEPSY
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DOI：
10.1212/wnl.44.11.2105
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发表时间：
1994-11-01
期刊：
影响因子：
9.9
通讯作者：
LIPTON, RB
中科院分区：
文献类型：
--
作者：
OTTMAN, R;LIPTON, RB
我们通过对1948名成年癫痫先证者及其1411名父母和兄弟姐妹进行结构化电话访谈，调查偏头痛和癫痫的合并症。癫痫定义为一生中有两次或两次以上无端发作，偏头痛定义为伴有以下两种或两种以上症状的严重头痛：单侧疼痛、悸动性疼痛、视觉先兆或恶心。40岁前患癫痫的先证者偏头痛的累积发病率为24%，有癫痫的亲属为23%，无癫痫的亲属为12%。采用Cox比例风险分析来控制患病年数和性别，先证人群偏头痛的发生率比为2.4 (95% CI, 2.02 ~ 2.89)，癫痫患者亲属与非癫痫患者亲属偏头痛的发生率比为2.4（1.58 ~ 3.79）。偏头痛风险在因头部外伤而患有癫痫的先证者中最高，但在按癫痫发作类型、发病年龄、癫痫病因和一级亲属癫痫史对先证者进行分层时，每一亚组先证者的偏头痛风险都明显高于未受影响的亲属。先证者偏头痛的年龄特异性发病率在癫痫发作后比癫痫发作前增加的程度更大，但在发病前5年以上和发病前1 ~ 5年也显著增加。这些结果表明偏头痛和癫痫密切相关，独立于发作类型、病因、发病年龄或癫痫家族史。
We investigated comorbidity of migraine and epilepsy by using information from structured telephone interviews with 1,948 adult probands with epilepsy and 1,411 of their parents and siblings. Epilepsy was defined as a lifetime history of two or more unprovoked seizures, and migraine as severe headaches with two or more of the following symptoms: unilateral pain, throbbing pain, visual aura, or nausea. Cumulative incidence of migraine to age 40 was 24% in probands with epilepsy, 23% in relatives with epilepsy, and 12% in relatives without epilepsy. Using Cox proportional hazards analysis to control for years at risk and gender, the rate ratio for migraine was 2.4 (95% CI, 2.02 to 2.89) among probands and 2.4 (1.58 to 3.79) among relatives with epilepsy in comparison with relatives without epilepsy. Migraine risk was highest in probands with epilepsy due to head trauma, but it was significantly higher in every subgroup of probands than in unaffected relatives when probands were stratified by seizure type, age at onset, etiology of epilepsy, and history of epilepsy in first-degree relatives. Age-specific incidence of migraine among probands was increased to a greater extent after onset of epilepsy than before, but it was also significantly increased more than 5 years before onset and 1 to 5 years before onset. These results indicate that migraine and epilepsy are strongly associated, independent of seizure type, etiology, age at onset, or family history of epilepsy.