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您请求的操作仅限于组中的用户:===先兆偏头痛=== ====描述====这种类型的头痛通常以抑郁、易怒、食欲不振为前兆，这可能是皮层抑制扩散的结果。感觉异常也可出现，其频率仅次于视觉症状。手和脸的感觉异常是最常见的，特别是舌头，这可以帮助区分短暂性脑缺血发作(TIA)。先兆期的言语困难反映了主导半球的参与。[[眩晕]]和头晕可能与脑干活动或周围血流变化有关[[前庭解剖与神经生理学|前庭]]]机制。
先兆由头痛(HA)之前或伴随的完全可逆的症状组成。先兆通常被描述为视野的变化。视觉图像会发生变化，可能会失去焦点，出现黑点和锯齿状闪光。它通常从靠近视觉中心的一个模糊点开始，可以形成一个星形，进一步发展成一个形状，称为防御工事(带角的半圆形)。这种闪烁的视觉由发光、明亮、闪烁的光谱颜色组成，就像棱镜捕捉光线一样。它可以合并暗斑(一个视觉区域似乎被阻塞，或缺失)。  The visual image fades as the headache begins. The headache is intense, throbbing, and usually contralateral to the visual field changes. ==== Clinical features ==== Recurrent disorder manifesting in attacks of reversible focal neurological symptoms that usually develop gradually over 5-20 minutes and last for less than 60 minutes. Headache with the features of migraine without aura usually follows the aura symptoms. Less commonly, headache lacks migrainous features or is completely absent. ==== Diagnostic Criteria ==== #At least 2 attacks fulfilling criterion 2 #Migraine aura fulfilling criteria 2 and 3 for one of the following: #*Typical aura with migraine headache #*Typical aura with non-migraine headache #*Typical aura without headache #*Familial hemiplegic migraine (FHM) #*Sporadic hemiplegic migraine #*Basilar-type migraine #Not attributed to another disorder ===== Typical Aura Without Headache ===== In some cases, the aura symptoms are not followed by headache. This becomes very important in the differential diagnosis if these symptoms begin after the age of 40. Aura without headache is seen primarily in men and in advancing age.  ===== Sporadic and Familial Hemiplegic Migraine ===== The presentation is migraine with aura, including motor weakness and impaired coordination. Prodromal symptoms include numbness of the face and arm that may spread to involve one side of the body. Basilar symptoms may present with dysphasia or aphasia causing difficulty with speech. Pain may be ipsilateral or contralateral to symptoms and on rare occasions, there is a loss of consciousness. Although the symptoms appear to resemble a TIA, migrainous infarction is rare. The age of onset is 10-15 years usually accompanied by a family history via chromosome 19 or 1. This type of migraine is considered sporadic if there is no 1st or 2nd degree relative with hemiplegic migraine. ===== Basilar-Type Migraine ===== Basilar migraine has a symptom profile that suggests posterior fossa involvement localizing to the vascular territory of the basilar artery- the brainstem, cerebellum, and occipital lobes.  The prodromal symptoms reflect brainstem dysfunction: altered level of consciousness, [[dysarthria]], tinnitus, [[ataxia]], [[diplopia]], symptoms in both the temporal and nasal fields of both eyes, and peripheral dysesthesias, followed occipital headache. These symptoms complicate differential diagnosis and can be confused with hydrops or vertebrobasilar TIA. 

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