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  • Migraines are more than just headaches.

    偏頭痛不只是頭痛罷了。

  • They're pre-headaches, post-headaches, sensitivities, nausea, fatigue and can even bring on food cravings.

    它們有頭痛前後的症狀、敏感、噁心、疲勞等問題,甚至會對食物產生渴望。

  • But most of all they are painful and frustrating for those who suffer from them.

    但最重要的是,受到那些症狀困擾的人,都很痛苦且感到挫折。

  • For years they were misunderstood, but now we know it comes down to two main things,

    多年來它們都受到誤解,但現在我們知道偏頭痛歸咎於兩個主要因素,

  • your genes and your brain.

    基因和大腦。

  • To really understand why migraines are so much more than headaches, first we have to know what headaches are.

    要真正了解為何偏頭痛不只是頭痛,首先必須知道頭痛到底是什麼。

  • My name is Rashmi Halker Singh.

    我是 Rashmi Halker Singh。

  • I'm a fellowship trained board, certified headache neurologist here at Mayo Clinic.

    我是通過資格考的研究醫生,梅奧醫學中心認證的頭痛神經學家。

  • I'm also the headache fellowship program director here at Mayo Clinic in Arizona.

    同時也是亞利桑那州梅奧醫學中心的頭痛研究計畫主任。

  • There's actually a huge book called the International Classification of Headache Disorders, which

    其實有一本很厚的書叫「國際頭痛疾病分類」,

  • has maybe 300 different diagnoses of different types of headache.

    其中不同類型的頭痛也許有 300 種不同診斷。

  • So when we say headache, all we mean by that is pain above the neck.

    說到頭痛時,我們所說的就是脖子以上的疼痛。

  • And yes, migraines are pains above the neck so they are headaches, but again, suffering

    沒錯,偏頭痛是脖子以上的疼痛,所以是頭痛沒錯,但一樣

  • from a migraine attack is much more than just having a headache.

    受到偏頭痛困擾不只是頭痛那麼簡單。

  • So migraine is actually a problem of brain dysfunction.

    偏頭痛其實是腦功能障礙。

  • It's a genetic disorder that is very common.

    它是相當常見的遺傳疾病。

  • So by diagnostic criteria you need to have recurrent headaches, whether it happened infrequently

    因此,根據診斷標準,你要有經常性的頭痛,不管是偶爾發作

  • or frequently, lasting 4 to 72 hours without medication.

    還是經常發作,在沒有藥物治療下,持續 4 到 72 小時。

  • And then in addition to that, the pain has to have at least two of the following four symptoms.

    除此之外,疼痛必須至少有以下四種症狀中的兩種。

  • The pain needs to be moderate or severe in intensity, and more intense on one side of the

    疼痛強度要在中度或強烈,頭的另一邊有更強烈的

  • head, throbs or pulses, and gets worse with activity.

    抽痛或跳動,並隨著活動而惡化。

  • But to stay on theme, a migraine is more than just experiencing pain.

    但言歸正傳,偏頭痛不只是經歷疼痛而已。

  • You also have to have either a sensitivity to light or sound or nausea.

    你還會對光線、聲音有敏感性,或者感到噁心。

  • In fact, migraine attacks come in four stages with a painful headache being just one of them.

    事實上,偏頭痛發作分為四階段,痛苦的頭痛只是其中之一。

  • Before the headache stage, some people, about one fourth of migraine sufferers, will experience

    在頭痛階段之前,大約四分之一的偏頭痛患者,

  • what is called an aura.

    會經歷俗稱的「預兆」。

  • When someone has a visual aura, they will see light spots, jagged lines, things like that in their vision.

    有人會有視覺上的預兆,他們會看到光點、鋸齒線,那些東西會出現在他們的視覺中。

  • Sometimes people will have a sensory aura as well in which they'll have like pins and

    有時他們會有感覺上的預兆,他們會感覺有別針

  • needles, tingling sensation up one limb.

    和大頭針,在腿上發出刺痛的感覺。

  • And again, this typically lasts 5 to 60 minutes and is typically followed pretty much

    而且,這通常持續 5 到 60 分鐘,

  • immediately by the headache.

    之後緊接著頭痛。

  • But before that, migraine sufferers will experience a prodrome, the first stage in the migraine attack.

    但在那之前,偏頭痛患者會經歷前驅期,這是偏頭痛發作的第一階段。

  • This stage can last an entire day and includes symptoms like increased yawning, trouble concentrating,

    這個階段可以持續一整天,包括增加打哈欠、注意力不集中

  • increased urination and even cravings for things like chocolate.

    排尿增加,甚至會對巧克力產生渴望。

  • Finally after the headache phase has ended a lot of my patients will tell me,

    最後頭痛階段結束後,很多病人會告訴我

  • you know, Doc, I have this like headache hangover.

    醫生,我這好像宿醉的頭痛。

  • And that's what we would call a Migraine postdrome.

    這是偏頭痛的後期症狀。

  • This is not fully understood exactly just yet, but we think it's probably a recovery phase within the brain.

    目前還尚未完全理解這點,但我們認為這可能是大腦內的恢復階段。

  • And they might feel just really tired or fatigued or still have trouble concentrating.

    他們可能會感到疲勞或疲憊,注意力甚至仍難以集中。

  • Just kind of still recovering from the whole episode.

    像是整個事件仍在復原。

  • So when we think about Migraine, those would be the four phases.

    想到偏頭痛時,會有四個階段。

  • Most of what we know has to do with the pain phase.

    我們所知的大部分都與疼痛階段有關。

  • And what we know is not a lot.

    而我們所知的非常有限。

  • It was once thought that migraines were caused by constriction and dilation of the blood

    曾經有人認為偏頭痛是因向大腦供血的血管

  • vessels that supply blood to the brain...

    收縮和擴張所引起的......

  • But we know that's not the case anymore.

    但已經知道完全不是這回事。

  • We know that Migraine is actually a problem of brain dysfunction.

    我們知道偏頭痛其實是腦功能異常。

  • It originates from the brain itself.

    它源自於大腦本身。

  • And it's a problem of pain processing.

    是處理疼痛的問題。

  • And there's a whole host of different components involved in this whole pain processing abnormality.

    整個處理疼痛的異常中,涉及到整個宿主不同的部分。

  • And because of that, there's lots of different genes involved as well.

    因此,有很多不同的基因也參與其中。

  • A few genes have been identified, but we're still learning more about this.

    已經找出部分基因,但我們仍須進一步了解。

  • So we know that genes are a part of migraines, you can be genetically predisposed to have these painful headaches.

    我們了解到基因也是偏頭痛的一部分,那在遺傳上就容易有討人厭的頭痛。

  • And researchers have identified the part of the brain involved with migraines and the

    研究人員已經確定大腦中與偏頭痛相關的部分,

  • lingering pain associated with them.

    以及相關的持續性疼痛。

  • Really a lot of our emphasis on migraine has to do with something called the trigeminal

    的確,偏頭痛有許多重點都與三叉神經尾核有關,

  • nucleus Caudalis, which is, something in the brainstem that's really important for pain processing.

    它是腦幹中負責處理疼痛的重要東西。

  • And when a migraine attack occurs, there are what we'd call trigeminal

    偏頭痛發作時,我們所說的三叉神經

  • afferents or nerve endings that also become activated and they will release CGRP.

    或神經末梢也會受到刺激,並釋放 CGRP。

  • CGRP stands for Calcitonin Gene-Related Peptide, and when released helps the pain continue,

    CGRP 的全名是抑鈣素基因系肽,釋放後有助於疼痛持續,

  • resulting in the long-drawn out painful migraine headache.

    導致長期痛苦的偏頭痛。

  • Now, how this exactly works is still unknown, but the correlation between CGRP's and migraine

    目前還不清楚到底是如何運作,但 CGRP 和偏頭痛之間的相關性

  • headaches has actually led to some better treatment options for patients.

    其實為患者帶來更好的治療選擇。

  • For the first time in history, we have preventive treatments designed to treat migraine based

    有史以來首次,我們在偏頭痛發作時,根據在大腦中所知的情況,

  • on what we know as to what happens in the brain during a migraine attack.

    採取預防性治療來對付偏頭痛。

  • And a lot of research has shown us that if you, you know, infused CGRP in a patient who's

    許多研究表明,如果在患有偏頭痛的患者中輸入 CGRP

  • susceptible to having Migraines, you can trigger a migraine attack.

    會引發偏頭痛的發作。

  • And if you block CGRP, that reduction in CGRP levels correlates with migraine improvement.

    而如果你阻斷 CGRP,那 CGRP 程度的降低與偏頭痛的改善有關。

  • So based on that information, we've been able to develop some new medications.

    因此,基於這些資訊,我們已經能開發出一些新藥物。

  • So you know, this is a really exciting time in the migraine world.

    這在偏頭痛界真的是振奮人心的時刻。

Migraines are more than just headaches.

偏頭痛不只是頭痛罷了。

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B2 中高級 中文 美國腔 頭痛 發作 階段 大腦 患者 基因

到底是什麼原因導致了偏頭痛? (What Really Causes a Migraine?)

  • 276 17
    Jerry Liu 發佈於 2021 年 01 月 14 日
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