对偏头痛相关眩晕的认识——夏瑞明.pptx

眩晕和偏头痛北京大学人民医院耳鼻喉科夏瑞明流行病学1眩晕：7%BPPV偏头痛：14-16%VM:O.89-1%眩晕+偏头痛VN理论值1.1%MD:O.2%实际值3.2%流行病学2-儿童眩晕MRV:36.3-45%心因性：0-4.1%创伤：10-14%中耳炎：0-3%VN:5-7.6%BPpV:0-1.8%MD:0-1.5%Table 1Literature reports of the most common causes of vertipo dizriness in children.MeanMigaineBPVVestibulor Menieres BIV凸chogenie M住OM批dOrthostatic5eU线Bdiseasevertigo位类山句pate港oaBower and Cotton 2341064(12写5(15写39%)26005(15算)39第0YAgostino et al.311282NIA15500(210311000530100Weiskeder and Fife 113311311t356(19g026)03(100Ravid et aL4611824(3910(16914s(1303制59Choung et25到1187(3114(251262(售2470na et al川11910917(14期23(1写1412221165012(1)65期43Erbek et al.14715011517(34期61224g112612m5(10%)Balatsouras et548911(291715281247%05(350Gruber et6间37142(323(8期82213期08(22写13Total subje电2412选(17写1361&7写5(76)11(15113(1红304122(写104(149(121写Wiener-Vacher 482000NA2520mNANANA0第NAF.M.Gioacchini et al.Intemational Journal of Pediatn(2014)偏头痛之头痛的特点反复发作的单侧中、重度搏动性头痛每次持续4-72小时日常活动可使之加重可伴有恶心/畏光/畏声Recurrent headache disorder manifesting in attackslasting 4-72 hours.Typical characteristics of theheadache are unilateral location,pulsating quality,moderate or severe intensity,aggravation by routinephysical activity and association with nausea and/orphotophobia and phonophobia偏头痛的机制头痛三叉神经血管系统学说主流学说，头痛信号的转换和调节。神经递质，如降钙素基因相关肽、5-羟色胺、去甲肾上腺素和多巴胺等，参与偏头痛的发病。先兆皮层扩步抑制(CSD)先兆和头痛有不同的机制耳聋耳鸣中