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什么导致偏头痛?

What Really Causes a Migraine?

Migraines are more than just headaches.
偏头痛不仅仅是头痛
They’re pre-headaches, post-headaches, sensitivities, nausea,
还可能在头痛前后引起敏感 恶心
fatigue and can even bring on food cravings.
疲劳 甚至还会影响食欲
But most of all they are painful and frustrating
但最主要的是 偏头痛会让人
for those who suffer from them.
感到痛苦和沮丧
For years they were misunderstood,
多年来 它们常常遭到误解
but now we know it comes down to two main things,
但现在我们知道 这归咎于两点
your genes and your brain.
你的基因和大脑
To really understand why migraines are so much more than headaches,
为真正弄清偏头痛不仅是头痛的原因
first we have to know what headaches are.
我们首先要知道 头痛是什么
My name is Rashmi Halker Singh.
我叫拉什米·哈尔克·辛格
I’m a fellowship trained board, certified headache neurologist here at Mayo Clinic.
我是梅奥诊所专业的头痛神经学家
I’m also the headache fellowship program director here at Mayo Clinic in Arizona.
也是亚利桑那州梅奥诊所头痛研究项目的主任
There’s actually a huge book called
有一本很大的书叫做
the International Classification of Headache Disorders, which
《头痛病的国际分类》
has maybe 300 different diagnoses of different types of headache.
里面大概有三百种判断不同类型头痛的方法
So when we say headache,
所以当我们说头痛时
all we mean by that is pain above the neck.
我们其实是说脖子以上的疼痛
And yes, migraines are pains above the neck
当然 偏头痛就是在脖子之上的痛
so they are headaches, but again, suffering
所以它们属于头痛 但是
from a migraine attack is much more than just having a headache.
偏头痛的发作又不仅是头痛
So migraine is actually a problem of brain dysfunction.
所以偏头痛实际上是大脑功能障碍的问题
It’s a genetic disorder that is very common.
这是一种很常见的遗传病
So by diagnostic criteria you need to have recurrent headaches,
因此根据诊断标准 你需要满足
whether it happened infrequently
在不吃药的情况下
or frequently, lasting 4 to 72 hours without medication.
持续4—72小时反复发作的头痛
And then in addition to that,
除此之外
the pain has to have at least two of the following four symptoms.
疼痛必须满足以下四个中的两个特征
The pain needs to be moderate or severe in intensity,
疼痛的程度中等或者严重
and more intense on one side of the head,
头部一侧的疼痛更剧烈些
throbs or pulses, and gets worse with activity.
感到脉搏跳动 活动时疼痛更剧烈
But to stay on theme, a migraine is more than just experiencing pain.
但话说回来 偏头痛不仅仅会感到头痛
You also have to have either a sensitivity to light or sound or nausea.
还会对光线 声音或恶心反应过度
In fact, migraine attacks come in four stages
实际上 偏头痛发作分为四个阶段
with a painful headache being just one of them.
头痛只是它们中的一个
Before the headache stage,
头痛发作之前
some people, about one fourth of migraine sufferers,
大概会有四分之一偏头痛患者
will experience what is called an aura.
会出现先兆
When someone has a visual aura,
当一个人出现视觉预兆时
they will see light spots, jagged lines, things like that in their vision.
他们会看到光点 锯齿线 视野中出现类似的东西
Sometimes people will have a sensory aura as well
有时人们也会出现感官上的预兆
in which they’ll have like pins and needles,
感觉就像有很多针
tingling sensation up one limb.
刺痛着身体
And again, this typically lasts 5 to 60minutes
同样 这个过程通常会持续5—60分钟
and is typically followed pretty much immediately by the headache.
紧跟着通常就是头痛
But before that, migraine sufferers will experience a prodrome,
但在此之前 偏头痛患者会有前驱症状
the first stage in the migraine attack.
偏头痛发作的第一阶段
This stage can last an entire day
这一症状可能会持续一整天
and includes symptoms like increased yawning, trouble concentrating,
其症状包括哈欠增多 注意力不集中
increased urination and even cravings for things like chocolate.
排尿增多 甚至想吃巧克力等
Finally after the headache phase has ended
最后 头不痛之后
a lot of my patients will tell me,
我的很多病人会跟我说
you know, Doc, I have this like headache hangover.
医生 我有头痛 宿醉的症状
And that’s what we would call a Migraine postdrome.
这就是我们所说的偏头痛后期症状
This is not fully understood exactly just yet,
我们还没有完全明白这一点
but we think it’s probably a recovery phase within the brain.
但我们认为 这可能是大脑的一个恢复阶段
And they might feel just really tired or fatigued or still have trouble concentrating.
他们可能会觉得很累 很疲劳 或者仍然无法集中注意力
Just kind of still recovering from the whole episode.
就是还没从整个过程中恢复过来
So when we think about Migraine, those would be the four phases.
当我们提到偏头痛时 就是这四个阶段
Most of what we know has to do with the pain phase.
我们所知道的大部分都与疼痛阶段有关
And what we know is not a lot.
我们知道的并不多
It was once thought that migraines were caused
人们曾经认为偏头痛是由
by constriction and dilation of the blood
向大脑供血的血管
vessels that supply blood to the brain…
收缩和扩张血液引起的…
But we know that’s not the case anymore.
但现在我们知道不是这么回事儿了
We know that Migraine is actually a problem of brain dysfunction.
我们知道 偏头痛实际上是大脑功能障碍的问题
It originates from the brain itself.
偏头痛病根在大脑本身
And it’s a problem of pain processing.
这是个疼痛处理的问题
And there’s a whole host of different components involved
在整个疼痛处理异常的过程中
in this whole pain processing abnormality.
有很多不同的成份
And because of that, there’s lots of different genes involved as well.
正因为如此 会有很多不同的基因参与其中
A few genes have been identified, but we’re still learning more about this.
我们已经确定了一些基因 但仍在学习更多相关方面的知识
So we know that genes are a part of migraines,
我们知道基因是引起偏头痛的一个原因
you can be genetically predisposed to have
从遗传学上来说 你更容易
these painful headaches.
患上这些头痛病
And researchers have identified the part
研究人员已经找出
of the brain involved with migraines and the
大脑中偏头痛以及
lingering pain associated with them.
偏头痛持续疼痛的相关部分
Really a lot of our emphasis on migraine has to do
我们关注的偏头痛很大程度上
with something called the trigeminal nucleus Caudalis,
与三叉神经核有关
which is,something in the brainstem that’s really important for pain processing.
也就是脑干中处理疼痛非常重要的那部分
And when a migraine attack occurs,
当偏头痛发作时
there are what we’d call trigeminal
会激活我们所说的
afferents or nerve endings that also become activated and they will release CGRP.
三叉传入神经或神经末梢 并释放CGRP
CGRP stands for Calcitonin Gene-Related Peptide,
CGRP就是降钙素基因相关肽
and when released helps the pain continue,
当它释放的时候 疼痛就会持续
resulting in the long-drawn out painful migraine headache.
导致长时间的偏头痛
Now,how this exactly works is still unknown,
如今 这是如何运作的还不得而知
but the correlation between CGRP’s and migraine
但是CGRP和偏头痛之间的相关性
headaches has actually led to some better treatment options for patients.
确实为患者带来了更好的治疗选择
For the first time in history,
有史以来第一次
we have preventive treatments designed to treat migraine based
基于我们所知道的偏头痛发作时大脑中
on what we know as to what happens
发生的情况 我们设计了
in the brain during a migraine attack.
偏头痛的预防性治疗法
And a lot of research has shown us that if you,
很多研究表明 如果你
you know, infused CGRP in a patient who’s susceptible to having Migraines,
给一个易患偏头痛的病人注射CGRP
you can trigger a migraine attack.
就会引起偏头痛
And if you block CGRP,
如果你阻断CGRP
that reduction in CGRP levels correlates with migraine improvement.
CGRP水平的降低与偏头痛的改善有关
So based on that information, we’ve been able to develop some new medications.
基于这些信息 我们已经开发出一些新的药物
So you know, this is a really exciting time in the migraine world.
因此 在偏头痛领域 这是一个激动人心的时刻

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视频概述

偏头痛仅仅只是会头痛吗?

听录译者

收集自网络

翻译译者

Yuuu

审核员

审核员 V

视频来源

https://www.youtube.com/watch?v=JOIR_CwX878

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