【摘要】 目的探讨线粒体脑肌病伴高乳酸血症及卒中样发作(MELAS)患者头痛的临床特征。方法收集46例伴头痛的MELAS综合征患者(头痛组)及14例无头痛患者(非头痛组)的临床资料进行分析。结果与非头痛组比较,头痛组癫痫发作率及恶心、呕吐率显著升高(均P<0.05),肢体无力、偏盲、失语、听力减退、认知障碍、共济失调、眼外肌麻痹、发热、发育异常以及腹泻、便秘比率的差异无统计学意义(均P>0.05)。头痛组患者血乳酸异常率显著高于非头痛组(P=0.013);肌肉病理活检、基因检测以及EEG异常率在两组间差异无统计学意义(均P>0.05)。头痛组枕叶及2处病灶比率显著高于非头痛组(均P<0.05)。结论MELAS头痛患者以偏头痛样头痛为主,更容易发生癫痫发作,血乳酸水平更高。受累病灶多在枕叶。更多还原

【Abstract】 Objective To investigate the characteristics of headache in patients with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes( MELAS). Methods Clinical data of 46 MELAS syndrome patients with headache( headache group) and 14 patients without headache( non-headache group) were analyzed. Results Compared with non-headache group,the rates of epilepsy,nausea and vomiting were significantly increased in the headache group( all P < 0. 05). There was no significant difference in the rates of weakness,hemianopsia,aphasia,hearing impairment,cognitive disorder,ataxia,extraocular myoparalysis,fever,dysplasia and diarrhea between the two groups( all P > 0. 05). The abnormal rate of blood lactate in the headache group was significantly higher than that in the non-headache group( P = 0. 013). There were no significant differences in the abnormal rates of muscle biopsy,gene detection and EEG examination between the two groups( all P > 0. 05). The ratios of occipital lobe and two lesions in headache group were significantly higher than those of non-headache group( all P < 0. 05). Conclusions Migraine-mimicking headache is the main kind of headache in MELAS patients.Seizure is more prone to occur,and blood lactic acid level is higher. Most of the involved lesions occur in occipital lobe.更多还原