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神经科医生破除11 个头痛和偏头痛的错误认知

Neurologists Debunk 11 Headache And Migraine Myths | Debunked

“Caffeine causes headaches.”
“咖啡因导致头痛”
Caffeine is a double-edged sword.
咖啡因是一把双刃剑
“The best way to cure a hangover is hangover food.”
“缓解宿醉最好的办法是吃解酒食物”
The best cure for a hangover is time.
时间才是缓解宿醉的良药
Oh, boy. “Migraines can be cured.”
哦 天哪 “偏头痛可以治愈”
Migraines cannot be cured.
偏头痛是无法治愈的
And I am sorry to deliver this news today.
很遗憾今天告诉大家这个消息
I’m Dr. Deena Kuruvilla.
我是蒂娜·库鲁维拉博士
I’m a neurologist and a headache specialist
是一名神经学家和头痛专家
with the Westport Headache Institute in Westport, Connecticut.
在康涅狄格州的韦斯特波特头痛研究所任职
Hi, I’m Dr. Cynthia Armand.
大家好 我是辛西娅·阿曼得
I’m a neurologist and headache specialist at the Albert Einstein College of Medicine
是爱因斯坦医学院的神经学家和头痛专家
and headache fellowship director at the Montefiore Headache Center.
同时也是蒙特菲奥里头痛中心的 研修医疗主任
And today we’ll be debunking myths about headaches and migraine.
今天我们将破除那些关于头痛和偏头痛的错误观念
Ugh. “Migraines are just headaches.”
呃 “偏头痛就是头痛”
That is just the most aggravating myth that I’ve ever seen.
这是我听过的最气人的错误言论
And I’m sure many of my patients will say the same thing.
而且我确信我的的很多病人也会这么说
I 100% agree.
我百分之百同意
A headache is a very nonspecific term
头痛是一个非常不具体的术语
for having discomfort or pain in the head.
泛指头部的疼痛和不适
Migraine is a neurological disorder
偏头痛是一种神经系统疾病
that’s not only headaches, but is associated with nausea,
它并不是单纯的头痛 还伴随其他症状
with vomiting, with sensitivity to light
比如恶心 呕吐 对光敏感
with sensitivity to sound and so many other symptoms.
对声音敏感等多种症状
It’s a disease. Just like asthma, just like diabetes.
它是一种疾病 就像哮喘 或是糖尿病
But within migraine disease, there are migraine attacks,
在偏头痛疾病的病程中 会有偏头痛症状发作
and an individual can have many or very little of them.
患者可能会经常发作或是很少发作
It’s very important to know the difference between headache and migraine,
了解头痛和偏头痛的区别是非常重要的
because the treatments are different.
因为治疗方案是不同的
“A nap will cure your headache.”
“小睡一会儿能治愈头痛”
There really isn’t evidence to show that a nap is helpful for managing a headache or a migraine.
并没有证据表明小睡对头痛或者偏头痛有帮助
Many of my patients tell me that they take medication and then they go take a nap,
我的很多病人告诉我他们会吃药 之后小睡一会儿
and by the time that they wake up, the headache or the migraine attack has gone.
等他们醒来之后 头痛或是偏头痛的症状就消失了
That creates a false sense of treatment.
因此产生了小睡能起到了治疗作用的错觉
I’ve certainly found that sleeping too much or sleeping too little
我很确定 睡太多或是睡太少
is a big trigger for patients with migraine.
都很容易诱发偏头痛患者的症状
So I always counsel patients: Keep your sleep times, your wake times the same every day
所以我总是建议患者每天在相同的时间睡觉和起床
so that you don’t end up triggering a migraine.
以避免诱发偏头痛
Instead of napping, and this depends on the person,
比起小睡 你可以根据自身情况选择治疗方案
you can start with medication that your doctor had prescribed to you,
可以使用医生给你开的处方药
some mindfulness and meditation,
做一些正念和冥想
and making sure that you keep your schedule consistent.
确保作息时间规律
“Caffeine causes headaches.”
“咖啡因导致头痛”
Caffeine is a double-edged sword.
咖啡因是一把双刃剑
Yes, caffeine can be a trigger to headaches,
是的 咖啡因是头痛的一个诱因
but caffeine can also be helpful for headaches.
但也能对治疗头痛有帮助
Have fun, drink your latte,
不用担心 继续喝拿铁吧
but it’s really important to recognize
但是意识到这一点很重要
increasing the amount of caffeine you take in
增加咖啡因的摄入量
can trigger more headache attacks or migraine attacks.
可能会引发更多头痛和偏头痛的发作
And also, right after the period that you increase
同样 在你增加摄入量一段时间之后
and you decide, “Oh, I’m gonna try and cut it down,”
你心想“我要试着少喝咖啡”
suddenly that abrupt withdrawal can also trigger a migraine attack or a headache.
这种突然减量也会引起头痛或者偏头痛发作
Now, caffeine can also be useful in treating headaches or migraine attacks as well.
咖啡因也可以被用于治疗头痛和偏头痛
Like Excedrin, that can have caffeine in it,
比如扑热息痛 就可以加入咖啡因
which is Excedrin Migraine.
就是扑热息痛的偏头痛版
Just remember, you’re adding that caffeine from Excedrin Migraine to the caffeine you’re already taking.
要记住 药物里的咖啡因和日常摄入的加起来
That could certainly produce a worsening of headaches.
很可能会导致头痛的加重
Just something to be cautious about.
一定要注意这一点
“Dehydration is the most common cause of headaches.”
“脱水是最常见的头痛原因”
That is definitely not true.
这绝对不是真的
Dehydration is not the most common cause for headaches in general.
总的来说脱水并不是头痛最常见的原因
The part that annoys me about this is “cause.”
其中让我困惑的是“原因”这个词
What you just talked about are triggers, right?
你刚才提到过诱因 对吧?
So triggers are certain circumstances or situations
诱因是指某些条件或者情况
that lower one’s threshold to have a migraine attack in someone who’s already susceptible.
会降低那些易感人群症状的发作阈值
While dehydration is a common trigger for folks,
虽然脱水是一个常见的诱因
there are so many different triggers that have been reported by patients.
但病人们报告过很多不同的诱因
The most common ones I hear about are alcohol,
我听过的最普遍的包括酒精
too much caffeine or suddenly stopping caffeine,
过多或者突然停止咖啡因摄入
not getting enough sleep, and stress.
睡眠不足 压力大
It’s really important to keep a headache diary or a migraine diary,
做一个头痛或是偏头痛的记录真的很重要
because that allows you to know more about your body,
这样可以更了解自己的身体
and that allows you to put tabs on triggers.
就可以给诱因分门别类
And when attacks happen
当症状发作时
that helps you decide with your doctor what really is triggering you,
这能帮助你和医生确认到底是什么诱发了症状
because what triggers one person may not trigger someone else.
因为使某个人症状发作的诱因对其他人不一定产生作用
Oh, boy. “Migraines can be cured.”
哦 天哪 “偏头痛可以治愈”
Migraines cannot be cured.
偏头痛并不能治愈
And I am sorry to deliver this news today.
很遗憾今天告诉大家这个消息
Essentially, migraine disease is managed.
重要的是控制偏头痛病症
Migraine management consists of preventive treatments,
这包括预防疗法
which may be a daily medication, a monthly injectable,
诸如每日服药 每月一针注射剂
or a procedure or treatment with a device,
或者是使用器械的疗法
which is a very popular non-pharmacological option now.
这是现在很流行的非药物疗法
We always recommend as-needed treatments
我们一直推荐按需治疗
to limit your disability with each individual attack.
在每一次症状发作时减少对日常生活的影响
And then we also talk about non-medication options.
我们还讨论了非药物疗法
We talk about meditation, mindfulness,
比如冥想 正念
acupuncture, vitamins.
针灸 维生素
There are so many options available now
现在有很多可用的疗法
that you can seek help to really get your life back.
你可以寻求帮助 从而恢复正常的生活
“The best way to cure a hangover is hangover food.”
“缓解宿醉最好的方法是吃解酒食物”
There’s no cure for hangovers.
宿醉并不是治好的
The best cure for a hangover is time.
而是通过时间慢慢缓解的
The duration really varies per person.
每个人需要的时间不同
I’ve heard 24 to 72 hours.
我听说过的有24到72小时不等
That sounds like a really long time,
听起来是很长的一段时间
but everyone’s body is different.
但是每个人的体质不同
Headaches are usually a symptom for hangovers because of two things.
头痛通常是宿醉的症状之一 有以下两个原因
The first thing is, we know alcohol to be a trigger for migraine attacks and headache in general.
第一 我们知道酒精是头痛和偏头痛的诱因
The body actually releases histamine with alcohol intake in general,
摄入酒精时 身体通常会释放组胺
and that can certainly also cause a migraine attack.
这也会导致偏头痛发作
And the other portion is the dehydration of the alcohol.
另一个原因就是酒精导致的脱水
Dehydration is a trigger for migraine attacks and headache.
脱水是头痛和偏头痛发作的诱因之一
You could aggressively hydrate yourself with water,
你可以拼命喝水来给身体补水
or you can receive fluids through an IV.
或者静脉注射液体
You can take acetaminophen or an anti-nausea medication.
也可以吃对乙酰氨基酚或者抗恶心的药物
These are all options that are out there to use before a night of drinking,
这些都是晚上喝酒前预防不适的选项
but certainly not proven enough for that purpose.
但缓解宿醉的效果还未被证明
“Taking Advil will always treat headaches and migraines.”
“吃布洛芬就能治愈头痛和偏头痛”
Advil is an as-needed over-the-counter medication
布洛芬是一种按需非处方药
which is meant to be used as-needed only less than two days a week
应该按需服用 且每周服用少于两天
and is not used as a preventive treatment.
而且不能作为预防手段
This is the bane of my existence, because when I see patients for the first time,
这是我的噩梦 因为很多病人第一次来求医的时候
they’re always on an over-the-counter anti-inflammatory medication.
他们总是在使用非处方抗炎药
What we call NSAIDs, the nonsteroidal anti-inflammatories.
我们称之为非甾体抗炎药
And these NSAIDs, like Advil, treat the inflammation portion.
这些药物 比如布洛芬 具有抗炎作用
However, migraine involves all sorts of chemicals,
但是 偏头痛是由多种化学成分共同作用引发的
and they wouldn’t so respond to the over-the-counter anti-inflammatories.
它们对这类非处方抗炎药并不总是能产生反应
If medications such as Advil are used more frequently,
如果频繁使用布洛芬之类的止痛药
they can produce medication-overuse headache.
会导致药物过度使用性头痛
The newer term for it is medication-adaptation headache.
更新的术语叫做药物适应性头痛
How I explain this is that your body kind of gets used to it,
对此我的解释是你的身体某种程度上习惯了药物
so you take more of the medication, and you get more headache,
所以你会摄入更多的药物 然后你头痛的次数更多
and it’s just this vicious cycle.
这就形成了恶性循环
If you find out that you’re using your as-needed medications like Advil too frequently,
如果你发现你使用布洛芬等按需止痛药过于频繁
please talk to your doctor about a preventive option
请和你的医生讨论出一个预防措施
that will overall cut down on your headaches,
以便能总体减少头痛发作次数
so you don’t have to use so much as-needed medications.
这样你就不用使用那么多按需药物了
Ooh.

“All migraines are the same.”
“所有偏头痛都是一样的”
No, not all migraine attacks are the same.
不 并不是所有偏头痛发作起来都一样
Migraines come in all different flavors, and we can differentiate them
偏头痛有各种不同的症状 我们可以对它进行分类
in terms of how often the migraine occurs, like chronic migraine versus episodic migraine.
按照发作的频率 分为慢性和急性偏头痛
So chronic means any attack that occurs 15 or more days,
慢性偏头痛是指发作15天及以上
and then episodic means less than 15.
急性偏头痛是指发作不超过15天
And then we can differentiate them on the symptoms that individuals have.
我们还可以按照患者的症状来分类
There can be something called hemiplegic migraine,
有一类称为偏瘫性偏头痛
where individuals have weakness on one side.
患者只有一侧有不适症状
There can be migraine with and without aura.
还可以分为先兆性和非先兆性偏头痛
And what aura is, is a transient neurologic symptom,
先兆是一种短暂的神经性症状
which could be something that you see in your vision that comes along.
可能是出现幻视
It could be numbness on one side of your body.
可能是某一侧身体的麻木
It can be difficulty talking.
也可能是失语
And then there can be other specific ones
还有一些特殊的偏头痛
like retinal migraine. That’s specific to the eye.
比如视网膜性偏头痛 症状发生在眼部
The different types of migraine have different risks and different management patterns.
不同类型的偏头痛有不同的风险和应对模式
For example, people who have migraine with aura may be at a slightly higher risk of stroke.
比如 先兆性偏头痛患者有稍高一些的中风概率
There may be a specific treatment that works for that type of migraine.
针对这一类型的偏头痛 有专门的治疗方法
So for counseling purposes and treatment purposes,
所以为了咨询和治疗的目的
we really need to know what type of migraine you have.
我们真的需要知道你患有哪种偏头痛
“Migraines and headaches only happen on one side of the head.”
“偏头痛和头痛只发作于头部的一侧”
It’s definitely false,
这当然是错的
but we always like a textbook definition of things.
但是我们总是喜欢教科书上的定义
If we look up what migraine is, most commonly you’ll find that it says
如果我们去查偏头痛是什么 会发现最常见的定义是
it’s one-sided throbbing headache that has nausea, vomiting.
它是一侧的头部跳痛 伴有恶心 呕吐
But actually, again, every individual with migraine is different.
事实上 每个偏头痛患者都是不一样的
Migraine pain can be in the forehead,
疼痛部位可能是前额
sides of the head, back of the head,
头部两侧 脑后
the face, the nose, and the neck.
脸部 鼻子 还有颈部
Around 80% or more of patients with migraine also have neck pain.
大概80%或者更多的偏头痛患者同时有颈部疼痛
There are more rare headache disorders that only occur on one side of the head.
还有更多罕见的头痛疾病也只发生在头部的一侧
Cluster headache happens on only one side of the head, classically.
比如丛集性头痛就是这样
So, the location of your pain doesn’t necessarily pinpoint what your diagnosis is.
所以头痛的部位并不能确定诊断结果
What I really find is it’s a compilation of symptoms,
我发现真正能帮助确诊的是症状的收集
which is why I always talk about the diary.
这就是我为什么一直强调做头痛记录
“Having a headache means something is wrong with your body.”
“头痛意味着身体出了问题”
Oh, that’s a very interesting question.
哦 这是个很有趣的问题
Having a headache doesn’t necessarily mean there’s something wrong with your body.
头痛并不一定说明身体有问题
Headaches can signal more dangerous things going on in the brain,
头痛可能预示着大脑中发生着更危险的状况
like a stroke, like a tumor,
比如中风 肿瘤
like a tear within one of the arteries of the head or neck.
或是头部或颈部的动脉撕裂
But there are everyday things that can cause headache.
但是也有一些日常活动可能引发头痛
Ponytail headaches, for example, are very common.
比如马尾辫头痛就非常普遍
You’re tying your hair back in that really tight bun.
你很用力地将头发扎成一个很紧的髻
-Braids. -Braids, yes!
-辫子 -对!
Braids do the same thing.
辫子也是一样的
Swim caps. There’s ice cream headache
还有泳帽 还有冰激凌头痛
where you eat that ice cream and you notice that headache that comes on right away
是在你吃冰激凌之后很快就会感觉到头痛
and that’s bacause you’re kind of stimulating the upper part of your palate with that cold temperature
因为低温刺激到了你上颚的上部
So it’s important to know the red flags of when something may signal something more dangerous.
所以知道哪些症状可能是更危险的警报是很重要的
If you already have headaches or migraine disease,
如果你已经患有头痛或是偏头痛疾病
you might want to pay attention to if there’s a changing pattern,
你需要注意的有:头痛模式是否改变
if it’s still responsive to the usual treatments that you take,
你平时使用的疗法是否一直有效
if you are having extra symptoms added to the migraine that you haven’t had before.
你是否出现了以前没有过的症状
Those are indications that you need to see your provider
这些迹象意味着你需要去看医生
to make sure to do some sort of workout for any other secondary cause.
确保去解决那些继发性因素
Ooh.

“Mental health has nothing to do with migraines.”
“心理健康和偏头痛无关”
Oh, no.
哦 不
I just can’t with this one.
我真的不同意这条
So, we have to set the record straight on this one.
我们要澄清这个问题
Migraine is the second-leading cause of disability worldwide.
偏头痛是世界范围内致残的第二大原因
And actually, 50% of individuals with migraine do experience anxiety disorders.
事实上 50%的偏头痛患者都经历过焦虑症
And what that’s called is comorbid conditions.
这叫做共病状况
We know that depression, anxiety and other mood conditions
我们知道抑郁 焦虑等负面情绪
are more likely to happen within individuals with migraine.
在偏头痛患者中更容易发生
Migraine affects individuals at home,
偏头痛会影响家庭成员
their ability to take care of their family,
影响他们照顾家庭的能力
their ability to earn a living,
挣钱的能力
their ability to enjoy and engage in social interaction.
参与和享受社交的能力
And a lot of the times that leads to guilt.
很多时候都会引起内疚
That leads to a sense of worthlessness.
导致患者觉得自己没用
And if you don’t treat one condition, it’s difficult to treat the other.
如果你不治疗一种状况 就很难治疗另一种
What we do is we treat both at the same time.
我们要做的就是同时治疗两种病症
Many of the brain chemicals that are released during a migraine attack,
偏头痛发作时 大脑会释放多种化学物质
like dopamine, serotonin, norepinephrine,
如多巴胺 血清素 去甲肾上腺素
they’re the same chemicals that are also involved in mood disorders like depression and anxiety.
抑郁 焦虑等情绪障碍也同样涉及这些化学物质
So a lot of these medications that are first indicated for mood disorders
所以很多一开始用来治疗情绪障碍的药物
actually work well in individuals with migraine.
其实对偏头痛患者也效果很好
There are individuals who specialize in both migraine and mood disorders that can help.
同时研究偏头痛的情绪障碍的专家也能够提供帮助
So, do you want to do the honors?
那么 你愿意为大家效劳吗?
Sure, I’d love to.
当然 我很乐意
Go ahead.
继续
Let’s really rip this one up.
我们真的应该把这个撕掉
Headaches and migraine disease are quite complex.
头痛和偏头痛这两种疾病都非常复杂
They’re experienced differently in many different individuals.
不同的患者都有不同的经历
So it’s really important to keep a diary.
所以做记录真的很重要
Keep track of your individual triggers and what really makes your headaches worse.
记录你自己病症发作的诱因 以及使你头痛加重的原因
And have that dialogue with your provider
和医生进行沟通
in order to help with proper management and treatment.
以得到更好的处理和治疗

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视频概述

两位权威神经学家和临床医师 共同解读11个关于头痛和偏头痛的常见错误认知

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视频来源

https://www.youtube.com/watch?v=Ab3nSeTc6I4

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