Epilepsi hastalarında migren sıklığı, tek başına epilepsisi olan hastalar ile epilepsi ve migren birlikteliği olan hastaların klinik karşılaştırılması
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Date
2006
Authors
Haki, Cemile
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Bu çalışmada epilepsili hastalarda migren sıklığının genel popülasyondan daha sık olup olmadığını, migren ve epilepsi birlikteliği gösteren hastaların ortak özelliklerini, varsa bu özelliklerin bize ne gibi ipuçları sağlayabileceğini, bu hastaları tek başına epilepsisi olan hastalarla demografik ve klinik olarak karşılaştırmayı amaçladık. Ayrıca epilepsili hastalarda nöbetle ilişkili başağrılarının sıklığı, klasifikasyonu ve klinik özelliklerini, migren benzeri nöbetle ilişkili başağrısı olan hastalar ve diğer hastaları karşılaştırarak, migren benzeri nöbetle ilişkili başağrısı olan hastalar için risk faktörlerini bulmayı amaçladık. Hastalar ve Yöntemler: Eylül 2005-Mart 2006 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı Epilepsi polikliniğine başvuran, yaşları 13-66 arasında değişen, 60'ı kadın 40'ı erkek toplam 100 epilepsi hastası izinleri alınarak çalışmaya alındı. Semptomatik epilepsisi, mental geriliği olan hastalar ve 13 yaşın altındaki çocuklar çalışma dışı bırakıldılar. Migren ve epilepsi birlikteliği olan hastalar ve tek başına epilepsisi olan hastalar belirlendikten sonra, bunlar demografik ve klinik özellikler açısından karşılaştırıldı. Ayrıca nöbetle ilişkili başağrıları demografik , klinik özellikler ve başağrısı tipleri açısından sorgulandı. Bulgular: Epilepsili hastalarındaki migren prevalansı ile normal popülasyondaki migren prevalansı arasında istatistiksel fark saptanmadı. Epilepsili hastalarda migren riski, epilepsi sendromu, nöbet tipleri, epilepsi süresi, nöbet başlangıç yaşı, nöbet sıklığı, kullandığı antiepileptik sayısı, yaş ve cinsiyet ile ilişkisiz olarak değerlendirildi. Migren ve epilepsi birlikteliği olan hastalarda ailede migren öyküsü, tek başına epilepsisi olan hastalara göre yüksekti. Migren ve epilepsi birlikteliği olan hastalarda auralı migren epidemiyolojik çalışmalara göre daha yüksek oranda gözlendi. Nöbetle ilişkili başağrısı sıklığı literatürlerle uyumlu idi. Nöbetle ilişkili başağrısı tipleri ile epilepsi sendromu, nöbet tipleri, epilepsi süresi, nöbet başlangıç yaşı, nöbet sıklığı, kullandığı antiepileptik sayısı, yaş, cinsiyet arasında ilişki saptanmadı. Nöbetle ilişkili başağrısı olanlarda daha sık olarak migren dışı başağrılarının olduğu gözlendi. Migren benzeri nöbetle ilişkili başağrısı olan hastalarda interiktal migren diğer hastalara göre daha sıktı. Sonuç: Verilerimiz migren ve epilepsi arasında bir bağlantı olabileceğini düşündürmektedir, ancak her iki durumun birlikte bulunduğu olgularda belli bir epilepsi özelliği gösteremedik. Yine de epilepsi ve migren birlikteliği olan hastalarda auralı migren sıklığını daha önce yapılan epidemiyolojik çalışmalardan daha fazla saptadık. Bu da birlikteliğin altında yatan patofizyolojik mekanizma olarak yayılan depresyonun katkısı olabileceği hipotezini desteklemektedir. Migren öyküsünün, migren benzeri nöbetle ilişkili başağrısında daha sık olduğunun gözlenmesi, migrenin, migren benzeri nöbetle ilişkili başağrısına eğilim yarattığını düşündürebilir.
Aim: In this study, we aimed to evaluate whether migraine is more frequent in patients with epilepsy compared with general population, to find out common features of patients with migraine and epilepsy togetherness and if there's any, to determine what kind of predictions these features can provide us and to compare patients with migraine and epilepsy together with epilepsy alone in term of demographics and clinical characteristics. And also we tried to reveal frequency, classification and clinical features of seizure related headaches in epilepsy patients and by comparing patients with migraine like seizure related headache with other patients we aimed to find out risk factors for patients with migraine like seizure related headache. Patients and methods: A total of 100 patients with epilepsy who referred to Uludag University Faculty of Medicine Neurology Department Epilepsy Clinic between date of September 2005 and March 2006 included in this study. Of those 60 were females and 40 males and the patients were aged between 13 and 66 years. Patients with symptomatic epilepsy and mental retardation and children under age of 13 years excluded for this study. After patients with epilepsy associated with migraine and epilepsy alone obtained, these were compared according to their demographic and clinical characteristics. Furthermore, seizure-related headaches investigated in term of demographic, clinical characteristics and headache types. Findings: A statistical difference wasn't determined between migraine prevalence in epilepsy patients and migraine prevalence in normal population. In patients with epilepsy migraine risk, epilepsy syndrome, seizure types, epilepsy duration, onset age of seizure, seizure frequency, number of used antiepileptics were evaluated free of age and gender relation. Patients with migraine and epilepsy togetherness had a higher family migraine history than patients with epilepsy alone. Migraine with aura has been more frequently observed in patients with migraine and epilepsy v togetherness according to epidemiologic studies. Seizure related headache frequency was consentient with literature. There wasn't a relation between seizure related headache types and epilepsy syndrome, seizure types, epilepsy duration, onset age of seizure, seizure frequency, number of used antiepileptics, age, gender. In subjects who have seizure related headaches more frequently observed that they have headaches not including migraine. In patients with migraine like seizure related headaches interictal migraine was more often than other patients. Conclusion: Our data suggest that there may be a relation between migraine and epilepsy but we couldn't reveal a certain epilepsy characteristic in cases holding two situations together. But anyway, we determined migraine with aura in patients with epilepsy and migraine togetherness more than previous epidemiologic studies.This supports hypotesis that suggests spreading depression has a contribution to pathophysologic mechanism underlying this togetherness. Due to observation that migraine history is more frequent in migraine like seizure related headache, it can be considered that migraine creates a tendency to migraine like seizure related headache.
Aim: In this study, we aimed to evaluate whether migraine is more frequent in patients with epilepsy compared with general population, to find out common features of patients with migraine and epilepsy togetherness and if there's any, to determine what kind of predictions these features can provide us and to compare patients with migraine and epilepsy together with epilepsy alone in term of demographics and clinical characteristics. And also we tried to reveal frequency, classification and clinical features of seizure related headaches in epilepsy patients and by comparing patients with migraine like seizure related headache with other patients we aimed to find out risk factors for patients with migraine like seizure related headache. Patients and methods: A total of 100 patients with epilepsy who referred to Uludag University Faculty of Medicine Neurology Department Epilepsy Clinic between date of September 2005 and March 2006 included in this study. Of those 60 were females and 40 males and the patients were aged between 13 and 66 years. Patients with symptomatic epilepsy and mental retardation and children under age of 13 years excluded for this study. After patients with epilepsy associated with migraine and epilepsy alone obtained, these were compared according to their demographic and clinical characteristics. Furthermore, seizure-related headaches investigated in term of demographic, clinical characteristics and headache types. Findings: A statistical difference wasn't determined between migraine prevalence in epilepsy patients and migraine prevalence in normal population. In patients with epilepsy migraine risk, epilepsy syndrome, seizure types, epilepsy duration, onset age of seizure, seizure frequency, number of used antiepileptics were evaluated free of age and gender relation. Patients with migraine and epilepsy togetherness had a higher family migraine history than patients with epilepsy alone. Migraine with aura has been more frequently observed in patients with migraine and epilepsy v togetherness according to epidemiologic studies. Seizure related headache frequency was consentient with literature. There wasn't a relation between seizure related headache types and epilepsy syndrome, seizure types, epilepsy duration, onset age of seizure, seizure frequency, number of used antiepileptics, age, gender. In subjects who have seizure related headaches more frequently observed that they have headaches not including migraine. In patients with migraine like seizure related headaches interictal migraine was more often than other patients. Conclusion: Our data suggest that there may be a relation between migraine and epilepsy but we couldn't reveal a certain epilepsy characteristic in cases holding two situations together. But anyway, we determined migraine with aura in patients with epilepsy and migraine togetherness more than previous epidemiologic studies.This supports hypotesis that suggests spreading depression has a contribution to pathophysologic mechanism underlying this togetherness. Due to observation that migraine history is more frequent in migraine like seizure related headache, it can be considered that migraine creates a tendency to migraine like seizure related headache.
Description
Yazarından yayınlama izni istenecektir.
Keywords
Epilepsi, Migren, Migren ve epilepsi birlikteliği, Nöbetle ilişkili başağrıları, Epilepsy, Migraine, Migraine and epilepsy togetherness, Seizure related headaches
Citation
Haki, C. (2006). Epilepsi hastalarında migren sıklığı, tek başına epilepsisi olan hastalar ile epilepsi ve migren birlikteliği olan hastaların klinik karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.