반복적인 의식저하와 전신마비를 보인 기저형 편두통 1례
A Case of Basilar Migraine Showing Repeated Change of Consciousness and Generalized Paralysis
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초록
저자들은 두통의 13세 남아에서 구토, 복시, 구음장애, 약 30분간의 의식 소실, 어지러움, 양측 감각이상 이후에 심한 두통이 나타나는 증상이 간헐적으로 반복되는 기저형 편두통 환자에서 flunarizine 및 topiramate 병합 예방요법으로 효과를 보인 1례를 경험하였기에 보고하는 바이다. 기저형 편두통은 전조 증상으로 드물게 의식장애나 양측 동시의 감각이상 등을 나타내므로 진단 및 치료에 있어 이에 대한 고려가 필요하며 예방요법의 시행에 있어 단일약물로 효과가 없는 경우 flunarizine 및 topiramate 등의 병합 예방요법을 고려할 필요가 있다.
Abstract
Basilar migraine is a rare type of migraine with complex symptoms including aura such as dysarthria, vertigo, tinnitus, and decreased level of consciousness. A 13-year-old male patient was presented with severe headache and immobility of whole body for 20 minutes after vomiting, dizziness, and dysarthria. Similar episode of headache and unconsciousness after vomiting happened 2 weeks ago prior to the visit. Vital signs were stable and pupils showed positive light reflex. Brain MRI and MRA, EEG, and electrocardiography revealed no abnormality. One day after discharge from hospital, patient revisited emergency room because of similar episode of headache. Preventive medication was started with flunarizine 5 mg per day. However, similar episodes of headache and loss of consciousness repeated three times over the next four months. Topiramate was then added with dose of 100 mg divided into two doses. Since then, the patient has been symptom free over 1 year.
참고문헌 (29)
- Olesen J, "International classification of headache disorders, second edition (ICHD-2): current status and future revisions", Cephalalgia, 26, pp.1409~1410 (2006)
- Kaniecki RG, "Basilar-type migraine", Curr Pain Headache Rep, 13, pp.217~220 (2009)
- Li Q, "Basilar-type migraine with coma: case reports and literature review", Pain Med, 12, pp.654~656 (2011)
- Zhou J, "Basilar-type migraine with coma aura: report of three cases", Cephalalgia, 29, pp.98~99 (2009)
- Muellbacher W, "Prolonged impaired consciousness in basilar artery migraine", Headache, 34, pp.282~285 (1994)
- Kirchmann M, "Basilartype migraine - Clinical, epidemiologic, and genetic features", Neurology, 66, pp.880~886 (2006)
- Bickerstaff ER, "The basilar artery and the migraine-epilepsy syndrome", Proc R Soc Med, 55, pp.167~169 (1962)
- Golden GS, "Basilar artery migraine in young children", Pediatrics, 56, pp.722~726 (1975)
- Sicuteri F, "A new nonvascular interpretation of syncopal migraine", Adv Neurol, 33, pp.199~208 (1982)
- Marsala, S. Z., "Basilar migraine mistaken for encephalitis", Neurol Sci, 33, pp.213~214 (2012)
- Ambrosini A, "A new mutation on the ATP1A2 gene in one Italian family with basilar-type migraine linked to the FHM2locus", Neurology, 64(6, Suppl.1), pp.A132~ (2005)
- D'Onofrio M, "A new mutation on the ATP1A2 gene in familial basilar migraine", Cephalalgia, 24, pp.149~ (2004)
- Robbins MS, "CACNA1A nonsense mutation is associated with basilar-type migraine and episodic ataxia type 2", Headache, 49, pp.1042~1046 (2009)
- Kozubski W, "Basilar-type migraine: pathophysiology, symptoms and signs, and treatment", Neurol Neurochir Pol, 39(4 Suppl 1), pp.S65~S67 (2005)
- De Romanis F, "Basilar migraine with electroencephalographic findings of occipital spike-wave complexes : a long-term study in seven children", Cephalalgia, 13, pp.192~196 (1993)
- Camfield PR, "Basilar migraine, seizures, and severe epileptiform EEG abnormalities", Neurology, 28, pp.584~588 (1978)
- Ganji S, "Basilar artery migraine: EEG and evoked potential patterns during acute stage", Headache, 26, pp.220~223 (1986)
- Ramelli GP, "EEG findings during basilar migraine attacks in children", Electroencephalogr Clin Neurophysiol, 107, pp.374~378 (1998)
- Frequin ST, "Recurrent prolonged coma due to basilar artery migraine. A case report", Headache, 31, pp.75~81 (1991)
- Jacome DE, "MRI studies in basilar artery migraine", Headache, 30(2), pp.88~90 (1990)
- Seto H, "Basilar artery migraine. Reversible ischemia demonstrated by Tc-99m HMPAO brain SPECT", Clin Nucl Med, 19, pp.215~218 (1994)
- Gazioglu S, "Basilar artery occlusion in migraine-like headache: a possible triggering effect of sumatriptan", Neurol Sci, 33, pp.125~128 (2012)
- Bardwell A, "Stroke in migraine as a consequence of propranolol", Headache, 27, pp.381~383 (1987)
- Klapper J, "Triptans in the treatment of basilar migraine and migraine with prolonged aura", Headache, 41, pp.981~984 (2001)
- Mathew NT, "ral triptans are effective and well-tolerated in migraine with neurological symptoms (basilar, hemiplegic, and familial migraine with complex neurological manifestations)", Neurology, 56(8, Suppl. 3), pp.A218~A219 (2001)
- Baron EP, "Acute treatment of basilar-type migraine with greater occipital nerve blockade", Headache, 50, pp.1057~1059 (2010)
- Pierzchala K, "Severe case of basilar migraine treated with flunarizine", Neurol Neurochir Pol, 26, pp.879~882 (1992)
- Lewis D, "A double-blind, dose comparison study of topiramate for prophylaxis of basilar-type migraine in children: A pilot study", Headache, 47, pp.1409~1417 (2007)
- d'Onofrio F, "Basilar-type migraine responsive to lamotrigine: three case reports", Neurol Sci, 28(5, Suppl. 2), pp.S239~S241 (2007)