mob taub hau, nyob hauv ib qho chaw thiab rov ua dua ob peb zaug hauv ib hlis, tej zaum yuav mob migraine. Kev kuaj mob ntawm tus kab mob no yuav tsum muaj kev tshawb fawb tshwj xeeb, vim nws tsis tuaj yeem lees paub tus kab mob tsuas yog los ntawm cov tsos mob lossis cov cim qhia sab nraud.
Cov tsos mob tseem ceeb
Ib yam ntawm kev kuaj mob migraine yog qhov mob hauv cheeb tsam. Nrog rau tus kab mob no, nws cuam tshuam rau thaj tsam ntawm lub cev thiab sab xub ntiag, nias qhov xav tau feem ntau cuam tshuam rau lub xeev ntawm lub cev ntawm lub zeem muag. Migraine mob yuav luag ib txwm ib leeg, tsis yog tsiv teb tsaws. Qee zaum, qhov mob tshwm sim pib hauv cheeb tsam occipital, tab sis tom qab ntawd txav mus rau hauv pliaj.
Ntxiv rau qhov mob taub hau, cov neeg mob migraine raug kev txom nyem los ntawm photosensitivity, mob tshwm sim rau lub suab nrov, suab nrov. Feem ntau, tawm tsam keeb kwm ntawm migraine, xeev siab tshwm sim nrog ntuav. Cov xwm txheej ntawm tus neeg thaum muaj kev tawm tsam tsis zoo heev uas nws tsis tuaj yeem koom nrog kev ua haujlwm ntawm lub cev lossis lub hlwb.
Aura as a sign of migraine
BTsis zoo li mob taub hau uas tshwm sim nrog lwm yam kab mob, migraine muaj ib qho tsos mob tshwj xeeb. Peb tab tom tham txog migraine aura - tag nrho cov tsos mob uas tso cai rau kev kuaj mob sib txawv.
Migraine nrog aura loj hlob sai, hauv ob peb feeb xwb. Feem ntau, cov cim qhia ua ntej kev tawm tsam hauv cov neeg mob yog qhov tsis pom kev thiab kev hais lus tsis zoo (piv txwv li, tsis pom kev pom, flickering, "flies" hauv lub qhov muag, tsis muaj peev xwm hais lus ib ntus, ib tus neeg lub suab), tsis muaj zog hauv cov ceg tawv, kev puas tsuaj hauv lub qhov muag. qhov kev xav ntawm saj thiab tsw, kev nkag siab ntawm qhov loj me nyob ib puag ncig cov khoom.
Thaum qhov kev tawm tsam ntawm mob migraine pib, aura ploj mus. Muaj cov xwm txheej thaum, tom qab lub ntsej muag ntawm aura, kev tawm tsam tsis ua raws, tab sis nws yog qhov tseeb dua los xav txog lawv qhov kev zam tsis tshua muaj.
Kev kuaj mob rau tus mob migraine
Kev kuaj mob yog ua tom qab cov txheej txheem tshawb fawb. Thawj kauj ruam hauv kev kuaj mob migraine yog kev kawm ntawm cov neeg mob tsis txaus siab thiab tsim cov keeb kwm ntawm cov paj hlwb. Cov txheej txheem tshawb fawb ntxiv rau kev xav tias tus kab mob no tsuas yog ua tiav yog tias daim duab kho mob tag nrho tsis meej rau tus kws tshaj lij, lossis tus kab mob tau ua raws li qhov xwm txheej txawv txawv.
Kev kuaj xyuas kom meej ua rau nws yuav luag tsis tuaj yeem kuaj pom cov tsos mob ntawm lub paj hlwb. Nyob rau tib lub sijhawm, myofascial syndrome yog qhov tseem ceeb rau kev kuaj mob migraine - nws tshwm sim thaum muaj kev tawm tsam ntawm txhua hom kab mob. Hais txog qhov muajqhia tias nro thiab mob hauv cov leeg nqaij pericranial. Raws li kev tawm tsam ntau zaus, qhov mob hnyav zuj zus.
Thaum kuaj xyuas cov neeg mob, tus kws kho mob paj hlwb xav txog lwm yam tseem ceeb hauv kev kuaj mob migraine - cov no yog cov tsos mob ntawm vegetovascular dystonia, uas suav nrog kev tawm hws ntawm ob txhais tes thiab xim cyanotic ntawm cov ntiv tes ntawm tes. Convulsive Syndrome uas tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev ua kom muaj zog neuromuscular ntau dhau tuaj yeem ua rau dystonia.
kab mob dab tsi tuaj yeem tsis meej nrog
Lub ntsiab pathology uas tau ua zoo ib yam yog mob taub hau. Qhov no tsis yog ib qho kab mob ywj pheej, tab sis yog ib qho mob uas tshwm sim tawm tsam keeb kwm ntawm qee qhov kev puas hlwb, mob plawv.
Tsis zoo li mob migraine, qhov mob taub hau tsis tshua mob siab, thiab tsis muaj qhov mob throbbing thaum muaj kev tawm tsam. Nrog rau qhov pathology no, cov neeg mob muaj kev xav zoo li yog ib yam dab tsi yog nyem lub taub hau heev. Localization nyob rau hauv nro taub hau yog ubiquitous. Cov tsos mob xws li xeev siab lossis photosensitivity tsis cuam tshuam nrog tus mob no.
Yog vim li cas rau kev txhim kho ntawm kev mob taub hau, tsis zoo li caj ces mob migraine, uas tuaj yeem muaj ntau yam ua rau muaj kev cuam tshuam, yog ib tus neeg nyob ntev hauv qhov tsis xis nyob rau caj dab lossis lub taub hau, qhov xwm txheej ntxhov siab.
Differential diagnosis of basilar thiab vestibular migraines
Neurologists paub qhov txawv ntawm ob hom mob hnyav tshaj plaws ntawm tus kab mob no. Thawj yog lub basilarmigraine, uas tshwm sim nrog bouts ntawm kiv taub hau nyob rau hauv ua ke nrog nrog impaired tsis nco qab, psychomotor abnormalities, nrog rau tsis tsim nyog mus ob peb vas swings. Hom kab mob thib ob yog vestibular: nws qhov kev tawm tsam tau tshwm sim tshwj xeeb yog kiv taub hau thiab hnov lus ib ntus, tsis mob taub hau.
Vestibular migraine yog qhov nyuaj tshaj plaws los kuaj mob vim tsis muaj mob. Qhov xwm ntawm migraine kiv taub hau kuj qhia los ntawm photophobia, ib qho kev mob tshwm sim rau lub suab nrov, nce cov tsos mob thaum lub sij hawm cev xeeb tub, thiab polyuria. Tsis zoo li basilar migraine, nrog rau hom kab mob vestibular, cov neeg mob muaj qhov txawv txav me me oculomotor. Thaum daim ntawv basilar yog tus cwj pwm los ntawm kev ua kom lub cev muaj zog ntawm lub vestibular apparatus, ib qho kev nyiam rau kev mob nkeeg.
Sib tham nrog cov kws tshaj lij tshwj xeeb
Nyob rau hauv tus txheej txheem ntawm kev tshuaj xyuas tus neeg mob, tus kws kho mob yuav xa tus neeg mob mus kuaj rau cov kws kho mob nqaim kom tsis suav cov kab mob uas tshwm sim lawv tus kheej li mob taub hau zoo li migraine. Yog xav tias tus kab mob no, yuav tsum tau kev sab laj:
- kws kho mob - txhawm rau kawm txog lub xeev ntawm cov nyiaj, txiav txim siab qhov pom kev pom thiab tsis suav nrog cov txheej txheem inflammatory thiab kis;
- kws kho hniav - txhawm rau ntsuas qhov mob ntawm qhov ncauj kab noj hniav, kuaj pom foci ntawm cov kab mob purulent, uas tuaj yeem ua rau mob taub hau;
- kws kho mob otolaryngologist - tsis suav nrog cov kab mob ntawm pob ntseg sab hauv thiab nruab nrab, sinusitis, Meniere's disease;
- vertebrologist - kev tshuaj xyuas ntawm tus txha caj qaum thiab lub ncauj tsev menyuam qaum nrog lub hom phiaj ntawmkev pom zoo lossis tsis suav nrog hernial formations thiab pinched qab haus huv.
Kev sab laj nrog cov kws tshaj lij saum toj no yuav tso cai rau koj tshawb pom qhov ua rau mob taub hau, thiab tsis suav nrog migraines lossis txiav txim siab qhov mob hnyav heev.
Electroencephalography
Qhov no yog txoj kev pheej yig tshaj plaws thiab tsis mob rau kev sib txawv migraine. Cov ntaub ntawv vestibular ntawm tus kab mob cuam tshuam rau lub xeev ntawm lub hlwb cov qauv, cov hlab ntsha tseem ceeb thiab cov hlab ntsha uas pub lub hlwb thaum lub sijhawm ua haujlwm ntau yam. Tsis tas li ntawd, ua tsaug rau encephalography, cov txheej txheem inflammatory lossis kab mob pathological tuaj yeem kuaj pom.
Tomography (CT thiab MRI)
Txhawm rau tshem tawm cov kev kuaj mob hauv lub paj hlwb, vascular aneurysms lossis oncological neoplasms, tus kws kho mob tuaj koom yuav sau ntawv tshuaj xyuas lub hlwb rau tus neeg mob siv kev suav tomography lossis cov duab sib nqus resonance. Hom kev kawm no tso cai rau koj los txiav txim siab tias qhov ua rau mob migraine yog cov txheej txheem txawv txav uas cuam tshuam rau ib feem ntawm lub taub hau lossis ob peb thaj chaw. Nyob rau tib lub sijhawm, tsis ntev dhau los no, cov kws tshawb fawb tau tso tawm cov qauv uas mob taub hau tsis txav mus rau thaj tsam uas qhov mob nyob hauv ib cheeb tsam.
Ua tsaug rau tomography, nws muaj peev xwm txiav txim siab txog cov xwm txheej hauv kev loj hlob ntawm cov kab mob paj hlwb uas ua rau pom qhov mob, nco txog migraine hauv qhov xwm txheej. Tsis tas li ntawd, qhov ua rau mob tshwm sim tuaj yeem ua rau muaj zog intracranial uas tshwm sim tawm tsam keeb kwm ntawm cov qog los yogmob aneurysms. Qhov no tuaj yeem txiav txim siab los ntawm kev kuaj mob hauv computer ntawm migraine hauv tsev kho mob.
Kev kho mob ntawm ischemic mob pib nrog MRI. Yog tias koj ua qhov kev ntsuam xyuas thaum muaj tus kab mob exacerbation, koj tuaj yeem pom qhov txo qis ntawm cov ntshav ncig thiab cov hlab ntsha ntse ua ntej qhov mob migraine.
txiaj ntsig ntawm MRI
Kev xaiv kom pom zoo rau ib txoj kev kuaj mob tshwj xeeb yuav tsum tau ua los ntawm tus kws kho mob uas tuaj koom raws li qhov anamnesis, tus neeg mob kev noj qab haus huv thiab cov duab dav dav ntawm tus kab mob. Yog tias tus kws kho mob txiav txim siab tias qhov kev kawm tsim nyog, nws yuav tsum qhia meej txog qhov ntsuas ntawm MRI kev kuaj mob migraine, suav nrog kev siv tus neeg sawv cev sib txawv.
Kev ntsuas magnetic resonance txiav txim siab hom migraine uas tshwm sim tawm tsam keeb kwm ntawm kev hloov pauv hauv cov hlab ntsha hauv hlwb. Feem ntau, MRI tau muab rau cov neeg mob hauv cov xwm txheej hauv qab no:
- lub sijhawm postoperative tom qab kev cuam tshuam neurosurgical;
- mob hnyav cerebrovascular (ischemic lossis hemorrhagic strokes);
- mob hlwb raug mob;
- kev tsis txaus siab ntawm qhov mob ntawm qhov tsis paub keeb kwm, tshwm sim hauv ib lub hemispheres ntawm lub hlwb;
- muaj kev pheej hmoo ntawm cerebral infarction.
Thaum twg CT zoo dua?
Magnetic resonance imaging tsis tas yuav tso cai rau kuaj pom neoplasms hauv chav kuaj mob. Migraine hauv cov poj niam lossis cov txiv neej tuaj yeem yog mob hlwb, uas tuaj yeem lees paub yam tsis muaj kev poob siab los ntawm kev suav tomography. Nyob rau tib lub sijhawm, nws yuav tsum tau sau tseg ib zaug ntxiv tias qhov kev txiav txim siab ntawm kev xaiv cov txheej txheem tseem nyob nrog tus kws kho mob tuaj koom. Tsis tas li ntawd, MRI thiab CT tsis yog ib qho kev tshawb fawb tshwj xeeb, tab sis lawv txhua tus tuaj yeem nqa cov ntaub ntawv tshiab txog tag nrho cov duab ntawm tus kab mob thiab tsis suav nrog cov teeb meem cuam tshuam.
Angiography yog dab tsi?
Tsis zoo li cov kev tshawb fawb yav dhau los, angiography yog tus txheej txheem cuam tshuam. Txhawm rau kawm txog lub xeev ntawm cov hlab ntsha ntawm lub paj hlwb ua ntej kev kuaj mob, tus neeg mob tau txhaj tshuaj nrog tus neeg sawv cev sib txawv, uas yuav muaj ntau yam tshuaj. Feem ntau, iodine thiab gadolinium yog siv, uas yog txhaj rau hauv cov hlab ntsha peripheral. Ob peb feeb tom qab, sai li sai tau raws li qhov sib piv tau muab faib rau tag nrho cov hlab ntsha thiab cov hlab ntsha intracranial, X-ray ntawm cheeb tsam hauv kev kawm tau pib. Angiography cov txiaj ntsig tau hloov mus rau hauv cov duab digital thiab tso tawm ntawm lub vijtsam saib.
Ua tsaug rau cov txheej txheem no, nws muaj peev xwm muab lub hom phiaj kev ntsuas ntawm lub xeev ntawm cov hlab ntsha tshwj xeeb, txhawm rau txhawm rau txhawm rau txhawm rau hauv lawv cov phab ntsa, qhov khoob, thiab qib ntawm elasticity. Tsis zoo li X-ray angiography, MRI angiography yog kim dua thiab tsis tas yuav siv qhov sib piv.
Yuav kuaj tus menyuam li cas
Tsis muaj qhov tshwj xeeb kuaj mob migraine hauv cov menyuam yaus. Cov niam txiv yuav tsum tau saib xyuas txhua tus menyuam qhov kev tsis txaus siab yog tias lawv cuam tshuam nrog mob taub hau thiab cov tsos mob xws li xeev siab, ntuav, hnov lus tsis zoo thiab qhov muag tsis pom kev. Yog hais tias ob peb ntu ntawm tus me nyuam lub migraine rov qab, nws yuav tsum tau qhiaNeurologist.
Tus kws kho mob yuav ua qhov kev kuaj pom thiab xam phaj. Tus kws kho mob tshwj xeeb yuav xav tau cov ntaub ntawv hais txog tus me nyuam noj dab tsi los yog ua ua ntej pib muaj tus kab mob tshwm sim, dab tsi tshwm sim ua ntej qhov no. Cov niam txiv raug txhawb kom khaws daim ntawv teev npe sau tseg txhua qhov kev hloov pauv thiab ua rau muaj mob migraine.
Feem ntau, tus kws kho mob neurologist kuaj tus me nyuam raws li kev tsis txaus siab thiab kev kuaj mob. Tsis tas li ntawd, ib tus kws paub txog kev paub txog yam tsis muaj kev tshawb fawb ntxiv yuav tuaj yeem ua qhov kev xav txog hom kab mob. Ntawm cov txheej txheem kuaj mob ntxiv, cov menyuam yaus raug sau npe electroencephalography, dopplerography lossis MRI ntawm lub hlwb los ntsuas qhov xwm txheej ntawm cov hlab ntsha loj. Rau cov menyuam yaus hnub nyoog qis dua 14 xyoos, cov txheej txheem xws li x-rays thiab CT scans tsis pom zoo vim tias lawv cuam tshuam rau lub cev loj hlob.
tshuaj kho mob migraine
Ntau tus ntseeg tias yam tsis tau tos cov txiaj ntsig ntawm kev kuaj mob, nws tsis tuaj yeem pib kho mob migraine. Qhov tseeb nws tsis yog. Lub hauv paus ntsiab lus ntawm kev kho tus kab mob no yog los txo cov tsos mob. Tshuaj kho mob migraine suav nrog kev noj tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob ntawm pawg NSAID.
Txhua tus ntawm lawv tau zoo tiv thaiv mob taub hau, tshem tawm qhov mob ntawm phab ntsa vascular. Qhov tseeb, non-steroidal anti-inflammatory compounds tshem tawm qhov ua rau mob mob. Ntawm qhov yooj yim ib qho NSAIDs rau kev kho mob migraine, nws tsim nyog sau tshuaj rauhauv paus:
- acetylsalicylic acid;
- Ibuprofen;
- acetaminophen;
- naproxena;
- nimesulide;
- ketorolac;
- Xefocam;
- Ydiclofenac;
- lornoxicam.
Yog tias, tom qab siv sijhawm ntev, cov tshuaj no tau tso tseg tsis ua haujlwm, lawv raug hloov los ntawm cov tshuaj kho mob ntau dua, uas muaj ob lossis ntau cov tshuaj nquag (piv txwv li, codeine thiab phenobarbital, metamizole thiab paracetamol). Qee tus ntawm lawv muaj vasoconstrictive zog, lwm tus ua kom lub paj hlwb thiab tshem tawm cov excitability ntawm cerebral cortex. Feem ntau, cov tshuaj no zoo dua los tiv thaiv kev mob migraine, tab sis lawv tsis tuaj yeem noj tsis tu ncua, vim tias feem ntau ntawm cov khoom xyaw ua rau muaj kev vam khom tshuaj.
