Author/Editor		Pogačnik, Tomaž
Title		Migrena: diagnostični kriteriji, klinična slika in zdravljenje
Translated title		Migraine: diagnostic criteria, clinical picture and therapy
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 38, št. Suppl 4
Publication year		1999
Volume		str. 19-33
Language		slo
Abstract		The purpose of this presentation is to provide an overview of migraine. The international classification of and diagnostic criteria for headaches are necessary in order to ensure that physicians diagnose patients with headache in the same way in different countries. Multiple studies have been performed on the prevalence of migraine. The lifetime prevalence of migraine is approximately 12%. The socioeconomic costs of migraine are very high. Migraine, a commonmedical problem, is not merely a recurrent headache. Various symptoms and signs may precede, accompany or follow the attacks of headache, thus determining different types of migraine as independent entities. migraine without aura and migraine with aura are the most frequent varieties. The medical history remains the main tool in the differential diagnosis of migraine. The results of neurological examination are normal in these disorders. The field of migraine pathophysiology has been characterised as a battleground for elaborate hypotheses. Cerebral blood flow changes, spreading depression, neurogenic inflammation, central dysnociception, hyperexcitability of the brain, genetic factors, etc. have all been identified as possible causes. Therapy for migraine includes general measures, psychological management, and physiological treatment modes as well as acute and prophylactic pharmacological treatment of headache attacks. The development of new treatment for relief of acute attactks of migraine headache continues to be an active area of neurological research.
Summary		Namen prispevka je širši pregled obravnave bolnikov z migreno. Mednarodna razvrstitev glavobolov in diagnostični kriteriji za posamezne oblike opredelitev so potrebni, ker omogočajo zdravnkom po svetu opredelitev glavobolov na enak način. Narejene so bile številne raziskave o prevalenci migrene, ki kažejo, da je med prebivalstvom ljudi z migreno okrog 12%. Socioekonomski stroški za bolnike z migreno so zelo visoki. Migrena, pogost medicinski problem, ni le ponavljajoči se glavobol. Različni simptomi in znaki lahko nastopijo pred napadi migrenskega glavobola ali pa po njih in tako določajo različne oblike migrene kot samostojne entitete. Najbolj pogosti obliki sta migrena z avro in migrena brez avre. Anamneza je še vedno najpomembnejša v diferencialni diagnozi migrene. Pri nevrološkem pregledu bolnikov z migreno ne najdemo izpadov. Za razjasnitev patofiziologije migrene je značilno, da sedanja razmišljanja slonijo na hipotetičnem povezovanju različnih fragmentov, ki predstavljajo izsledke številni preiskav. Spremembe možganskega krvnega pretoka, "razširjajoča se drepresija", t.i. nevrogeno vnetje, centralna disnociceptivnost, hiperekscitabilnost možganov, genetski dejavniki itd. smo možni vzroki za nastanek migrene. Zdravljenje migrene vključuje splošne urkepe, psihološko vodenje, fiziološke načine zdravljenja, akutno in preventivno zdravljenje migrenskih napadov z zdravili. Razvoj novih zdravil za olajšanje akutnih napadov migrenskega glavobola je še nadalje aktivno področje raziskav v nevrologiji.
Descriptors		MIGRAINE DIAGNOSIS, DIFFERENTIAL