偏頭痛
Migraine

context: zh_tw: 偏頭痛（英語：Migraine）是一種出現反覆輕度或重度頭痛的慢性疾病，通常伴有各種自主神經系統症狀。偏頭痛的英文 “Migraine” 一詞源於希臘語ἡμικρανία（hemikrania），意為 “頭部一側的疼痛”，其中，ἡμι- （hemi-），意為 “一半”，κρανίον（kranion），意為 “顱骨”。通常這種頭痛為單側性質（僅涉及一側頭部），並伴有搏動，可持續 2-72 小時。相關症狀可能包括噁心、嘔吐、對光線更加敏感、對聲音更加敏感，且肢體活動會加重疼痛的感覺。三分之一的偏頭痛患者均能感到病症先兆：短暫的視覺、感覺、語言或肢體障礙都意味著頭痛即將發作。偏頭痛的病因被認為是環境因素和遺傳因素的綜合作用所致。大約三分之二的病例都有遺傳因素的原因。荷爾蒙水平的波動也可能是一個因素：在青春期之前，受到偏頭痛影響的男童比女童要稍多，但在此之後，受到偏頭痛影響的女性則比男性要多出兩至三倍。通常在懷孕期間，偏頭痛的影響會減弱。偏頭痛的準確致病原理目前尚不得而知。但人們普遍認為這是因為神經血管紊亂所導致的。目前主要的病理將其解釋為大腦皮層的興奮度增強，以及腦幹中三叉神經核裡的神經元的痛感控制異常。推薦初始治療可使用簡單的鎮痛藥，如布洛芬和醋氨酚來治療頭痛，而使用止吐劑來治療噁心，防止嘔吐。特殊藥劑，如曲普坦類或麥角胺則可在簡單的鎮痛藥效果不佳時選用。全球來看，約有 15% 的人群在一生中的某一個時段會受到偏頭痛的影響。
en: A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one-third of people have an aura: typically a short period of visual disturbance that signals that the headache will soon occur. Occasionally, an aura can occur with little or no headache following it.Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families. Changing hormone levels may also play a role, as migraines affect slightly more boys than girls before puberty and two to three times more women than men. The risk of migraines usually decreases during pregnancy. The underlying mechanisms are not fully known. They are, however, believed to involve the nerves and blood vessels of the brain.Initial recommended treatment is with simple pain medication such as ibuprofen and paracetamol (acetaminophen) for the headache, medication for the nausea, and the avoidance of triggers. Specific medications such as triptans or ergotamines may be used in those for whom simple pain medications are not effective. Caffeine may be added to the above. A number of medications are useful to prevent attacks including metoprolol, valproate, and topiramate.Globally, approximately 15% of people are affected by migraines. It most often starts at puberty and is worst during middle age. In some women, they become less common following menopause. As of 2016, it is one of the most common causes of disability. An early description consistent with migraines is contained in the Ebers papyrus, written around 1500 BCE in ancient Egypt. The word "migraine" is from the Greek ἡμικρανία (hemikrania), "pain on one side of the head", from ἡμι- (hemi-), "half", and κρανίον (kranion), "skull".
qas: question: zh_tw: 頭痛的家族遺傳病例佔多大比例？
en: What percentage of cases run in Family with headaches?
answers: zh_tw: text: 三分之二
en: text: two-thirds

question: zh_tw: 什麼會影響偏頭痛的產生？
en: what is thought to play a part in headaches?
answers: zh_tw: text: 荷爾蒙水平的波動
en: text: Changing hormone levels

question: zh_tw: 導致偏頭痛的原因是什麼？
en: What causes migraines?
answers: zh_tw: text: 環境因素和遺傳因素的綜合作用所致

context: zh_tw: 偏頭痛通常是區域性、反覆發作和自限性的嚴重頭痛，並伴有自主神經系統的相關症狀。有偏頭痛史的人群中有 15-30% 都有病發先兆並且，有偏頭痛病發先兆的人群，還經常出現無先兆即發病的情況。疼痛劇烈程度、頭痛持續時間和發作頻率則因人而異。持續時間超過 72 小時的偏頭痛被稱為偏頭痛持續狀態。偏頭痛可能有四個階段，儘管在發病時並非所有階段都會出現，它們是：
en: Migraines typically present with self-limited, recurrent severe headache associated with autonomic symptoms. About 15–30% of people with migraines experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura. The severity of the pain, duration of the headache, and frequency of attacks are variable. A migraine lasting longer than 72 hours is termed status migrainosus. There are four possible phases to a migraine, although not all the phases are necessarily experienced:
qas: question: zh_tw: 偏頭痛需要持續多長時間才能被認為是偏頭痛持續狀態？
en: How long does a migraine have to last to be considered migrainosus?
answers: zh_tw: text: 超過 72 小時
en: text: longer than 72 hours

context: zh_tw: 許多人在發病時願意找一個光線黯淡而舒適安靜的房間待著。其它症狀還包括：視線模糊、鼻塞、腹瀉、尿頻、臉色蒼白或出汗；還可能出現頭皮腫脹或敏感，以及頸部僵硬的情況。相關症狀在老年人群中比較少見。
en: Classically the headache is unilateral, throbbing, and moderate to severe in intensity. It usually comes on gradually and is aggravated by physical activity. In more than 40% of cases, however, the pain may be bilateral and neck pain is commonly associated with it. Bilateral pain is particularly common in those who have migraines without an aura. Less commonly pain may occur primarily in the back or top of the head. The pain usually lasts 4 to 72 hours in adults, however in young children frequently lasts less than 1 hour. The frequency of attacks is variable, from a few in a lifetime to several a week, with the average being about one a month.The pain is frequently accompanied by nausea, vomiting, sensitivity to light, sensitivity to sound, sensitivity to smells, fatigue and irritability. In a basilar migraine, a migraine with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a sense of the world spinning, light-headedness, and confusion. Nausea occurs in almost 90% of people, and vomiting occurs in about one-third. Many thus seek a dark and quiet room. Other symptoms may include blurred vision, nasal stuffiness, diarrhea, frequent urination, pallor, or sweating. Swelling or tenderness of the scalp may occur as can neck stiffness. Associated symptoms are less common in the elderly.Rarely, an aura occurs without a subsequent headache. This is known as an acephalgic migraine or silent migraine; however, it is difficult to assess the frequency of such cases because people who do not experience symptoms severe enough to seek treatment may not realize that anything unusual is happening to them and pass it off without reporting any problems.
qas: question: zh_tw: 基底型偏頭痛患者更喜歡什麼樣的光照條件？
en: What light conditions do people with basilar migraine prefer?
answers: zh_tw: text: 光線黯淡
en: text: dark

context: zh_tw: 針對雙胞胎的研究中，有 34%-51% 的遺傳因素表明他們可能會患偏頭痛。比起無先兆偏頭痛，這種遺傳關係在有先兆偏頭痛中表現得更為明顯。一系列特殊的基因變異更是逐漸的增加了患病風險。單基因病導致的偏頭痛尚屬罕見。其中之一就是家族性偏癱型偏頭痛，這是一種有先兆偏頭痛，屬於常染色體顯性遺傳現象。這種生理失調的情況與離子轉移中導致的蛋白質基因編碼變異相關聯。另一種導致偏頭痛的基因失調是 CADASIL 綜合症，或伴皮質下梗死及白質腦病常染色體顯性遺傳性腦動脈病。
en: Studies of twins indicate a 34% to 51% genetic influence of likelihood to develop migraine headaches. This genetic relationship is stronger for migraines with aura than for migraines without aura. A number of specific variants of genes increase the risk by a small to moderate amount.Single gene disorders that result in migraines are rare. One of these is known as familial hemiplegic migraine, a type of migraine with aura, which is inherited in an autosomal dominant fashion. Four genes have been shown to be involved in familial hemiplegic migraine. Three of these genes are involved in ion transport. The fourth is an axonal protein associated with the exocytosis complex. Another genetic disorder associated with migraine is CADASIL syndrome or cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. One meta-analysis found a protective effect from an angiotensin converting enzyme polymorphisms on migraine. The TRPM8 gene, which encodes for a cation channel, has been linked to migraines.
qas: question: zh_tw: 基因病導致偏頭痛的頻率有多高？
en: How often can gene disorders cause migraine?
answers: zh_tw: text: 罕見
en: text: rare

context: zh_tw: 室內外環境中可能觸發偏頭痛的因素已被證明為缺乏足夠的證據，但醫生仍舊建議偏頭痛患者可以在室內空氣質量和採光方面採取一定的預防性措施。曾經有人認為，聰明的人更易患偏頭痛，但這種說法目前並無根據。
qas: question: zh_tw: 對於偏頭痛，曾經有什麼認識？
en: What used to be the belief behind migraines?
answers: zh_tw: text: 聰明的人更易患偏頭痛

context: zh_tw: 有先兆偏頭痛，又稱 “經典偏頭痛”，即伴有先兆出現的偏頭痛。比較少見的情況是，先兆之後不出現頭痛症狀，或先兆之後出現的為非偏頭痛型頭痛症狀。其它兩種型別是家族性偏癱型偏頭痛和散發性偏癱性偏頭痛，這種偏頭痛的患者患病時通常伴有先兆和行動困難。若患者的近親屬出現同樣症狀，即為 “家族性”，否則即為 “散發性”。另外一種型別是基底動脈型偏頭痛，即出現頭痛和先兆症狀時通常伴有構音障礙、眩暈] 耳鳴或其它一些與腦幹相關的症狀，但沒有行動困難的問題。這種型別的偏頭痛最初被認為是由於基底動脈痙攣導致的，該動脈是支援腦幹的動脈。
en: Migraine with aura, or "classic migraine", usually involves migraine headaches accompanied by an aura. Less commonly, an aura can occur without a headache, or with a nonmigraine headache. Two other varieties are familial hemiplegic migraine and sporadic hemiplegic migraine, in which a person has migraines with aura and with accompanying motor weakness. If a close relative has had the same condition, it is called "familial", otherwise it is called "sporadic". Another variety is basilar-type migraine, where a headache and aura are accompanied by difficulty speaking, world spinning, ringing in ears, or a number of other brainstem-related symptoms, but not motor weakness. This type was initially believed to be due to spasms of the basilar artery, the artery that supplies the brainstem. Now that this mechanism is not believed to be primary, the symptomatic term migraine with brainstem aura (MBA) is preferred.
qas: question: zh_tw: 基底動脈的功能是什麼？
en: what is the function of the basilar artery?
answers: zh_tw: text: 支援腦幹
en: text: supplies the brainstem

context: zh_tw: 針對腹性偏頭痛的診斷頗具爭議。有證據表明，不伴有頭痛的週期性腹痛也許是偏頭痛的一種型別。或者至少也是偏頭痛的一種先兆。這種型別的疼痛和先兆一樣，也許會或也許不會在之後出現偏頭痛現象，這種疼痛通常會持續幾分鐘到幾小時。在個人典型偏頭痛或有偏頭痛家族史的人群中，這種疼痛時常出現。其它被認為是先兆的症狀包括：週期性嘔吐症狀和兒童良性陣發性眩暈。
en: The diagnosis of abdominal migraines is controversial. Some evidence indicates that recurrent episodes of abdominal pain in the absence of a headache may be a type of migraine or are at least a precursor to migraines. These episodes of pain may or may not follow a migraine-like prodrome and typically last minutes to hours. They often occur in those with either a personal or family history of typical migraines. Other syndromes that are believed to be precursors include cyclical vomiting syndrome and benign paroxysmal vertigo of childhood.
qas: question: zh_tw: 誰最有可能患有偏頭痛？
en: Who are most likely to have migraines?
answers: zh_tw: text: 個人典型偏頭痛或有偏頭痛家族史的人
en: text: those with either a personal or family history

context: zh_tw: 出現與偏頭痛類似症狀的其它情況包括：顳動脈炎、叢集性頭痛、急性青光眼、腦膜炎和蛛網膜下腔出血。顳動脈炎通常在 50 歲以上的人群中出現，表現為在太陽穴處的跳痛；叢集性頭痛表現為單側鼻塞、眼眶附近出現淚流、激痛；急性青光眼與視力問題相關聯；腦膜炎則伴有發熱；而蛛網膜下出血則發病非常迅速。緊張性頭痛通常在頭部兩側發生，其疼痛嚴重性和妨礙行動方面均不及偏頭痛。
en: Other conditions that can cause similar symptoms to a migraine headache include temporal arteritis, cluster headaches, acute glaucoma, meningitis and subarachnoid hemorrhage. Temporal arteritis typically occurs in people over 50 years old and presents with tenderness over the temple, cluster headaches presents with one-sided nose stuffiness, tears and severe pain around the orbits, acute glaucoma is associated with vision problems, meningitis with fevers, and subarachnoid hemorrhage with a very fast onset. Tension headaches typically occur on both sides, are not pounding, and are less disabling.Those with stable headaches that meet criteria for migraines should not receive neuroimaging to look for other intracranial disease. This requires that other concerning findings such as papilledema (swelling of the optic disc) are not present. People with migraines are not at an increased risk of having another cause for severe headaches.
qas: question: zh_tw: 顳動脈炎在哪裡會發生？
en: When do temporal arteritis occur?
answers: zh_tw: text: 50 歲以上的人群
en: text: in people over 50 years old

context: zh_tw: 治療主要分三個主要方面：避免觸發、控制急性症狀和藥物預防。在頭痛發作前期，使用藥物會更加有效。頻繁使用藥物則可能導致用藥過度性頭痛，從而使得頭痛愈發嚴重和頻繁。使用曲普坦類藥物、麥角胺和止痛劑時可能出現這種情況，尤其是麻醉性止痛劑。
qas: question: zh_tw: 什麼時候使用藥物有最佳效果？
en: When should you use medication for maximum effect?
answers: zh_tw: text: 頭痛發作前期

question: zh_tw: 大量用藥會增加哪種症狀？
en: What type of symptom arises from the significant use of medications?
answers: zh_tw: text: 頭痛

context: zh_tw: 麥角胺和雙氫麥角胺是以前用於治療偏頭痛的處方藥，現在仍在使用，後者有鼻噴劑和注射針劑兩種形式。它們同曲普坦類藥物同樣有效，但價格卻更為低廉，且其副作用也通常為良性的。對於最為虛弱的病例，如持續性偏頭痛患者，這些藥物是最為有效的治療方式。
en: Ergotamine and dihydroergotamine are older medications still prescribed for migraines, the latter in nasal spray and injectable forms. They appear equally effective to the triptans and experience adverse effects that typically are benign. In the most severe cases, such as those with status migrainosus, they appear to be the most effective treatment option. They can cause vasospasm including coronary vasospasm and are contraindicated in people with coronary artery disease.
qas: question: zh_tw: 雙氫麥角胺處方藥可以有哪幾種形式？
en: What type of forms can dihydroergotamine be prescribed as?
answers: zh_tw: text: 鼻噴劑和注射針劑兩種形式
en: text: nasal spray and injectable forms

context: zh_tw: 偏頭痛患者的遠期預後是可變的。多數偏頭痛患者會因病出現一段時間的勞動力喪失，然而通常來說患者病情還比較溫和，而且與死亡率的增加也沒有關聯。偏頭痛主要有四種模式：症狀可完全消失；症狀會持續存在，但隨著時間逐漸減輕；症狀以同樣的頻率和嚴重程度持續出現或者偏頭痛發作變得愈加嚴重和頻繁。有先兆偏頭痛似乎是發生缺血性卒中的一個危險因素，該病患者出現缺血性中風的風險是常人的兩倍。年紀輕、女性、使用激素避孕以及吸菸都會進一步增加這種風險。有先兆偏頭痛似乎與頸動脈夾層的發生也存在關聯。而無先兆偏頭痛似乎不是缺血性卒中的危險因素。該病與心臟問題的關係仍不確定，僅有一項研究支援存在這種關聯。但總體看來，偏頭痛似乎並沒有增加患者死於卒中或心臟病的風險。對有先兆偏頭痛的患者進行預防性治療，可能會預防相關卒中的發生。
en: Long-term prognosis in people with migraines is variable. Most people with migraines have periods of lost productivity due to their disease; however typically the condition is fairly benign and is not associated with an increased risk of death. There are four main patterns to the disease: symptoms can resolve completely, symptoms can continue but become gradually less with time, symptoms may continue at the same frequency and severity, or attacks may become worse and more frequent.Migraines with aura appear to be a risk factor for ischemic stroke doubling the risk. Being a young adult, being female, using hormonal birth control, and smoking further increases this risk. There also appears to be an association with cervical artery dissection. Migraines without aura do not appear to be a factor. The relationship with heart problems is inconclusive with a single study supporting an association. Overall however migraines do not appear to increase the risk of death from stroke or heart disease. Preventative therapy of migraines in those with migraines with auras may prevent associated strokes. People with migraines, particularly women, may develop higher than average numbers of white matter brain lesions of unclear significance.
qas: question: zh_tw: 卒中或心臟病死亡風險增加與什麼健康狀況無關？
en: Increased risk of death by stroke or heart disease is not associated with what medical condition?
answers: zh_tw: text: 偏頭痛
en: text: migraines

context: zh_tw: 全球範圍內，近 15% 的人（或約十億人）飽受偏頭痛的困擾。在美國，每年約有 6% 的男性和 18% 的女性出現過一次偏頭痛，而他們一生中患偏頭痛的風險分別為 18% 和 43%。在歐洲，有 12-28% 的人在他們一生中的某個時候曾患過偏頭痛，與此同時，約有 6-15% 的成年男性和 14-35% 成年女性每年至少出現一次偏頭痛。在亞洲和非洲國家，偏頭痛的發病率比西方國家略低一些。慢性偏頭痛發生在大約 1.4% 至 2.2% 的人口當中。
en: Worldwide, migraines affect nearly 15% or approximately one billion people. It is more common in women at 19% than men at 11%. In the United States, about 6% of men and 18% of women get a migraine in a given year, with a lifetime risk of about 18% and 43% respectively. In Europe, migraines affect 12–28% of people at some point in their lives with about 6–15% of adult men and 14–35% of adult women getting at least one yearly. Rates of migraines are slightly lower in Asia and Africa than in Western countries. Chronic migraines occur in approximately 1.4 to 2.2% of the population.These figures vary substantially with age: migraines most commonly start between 15 and 24 years of age and occur most frequently in those 35 to 45 years of age. In children, about 1.7% of 7 year olds and 3.9% of those between 7 and 15 years have migraines, with the condition being slightly more common in boys before puberty. During adolescence migraines become more common among women and this persists for the rest of the lifespan, being two times more common among elderly females than males. In women migraines without aura are more common than migraines with aura, however in men the two types occur with similar frequency.During perimenopause symptoms often get worse before decreasing in severity. While symptoms resolve in about two thirds of the elderly, in between 3 and 10% they persist.
qas: question: zh_tw: 飽受偏全球範圍內，有多少人飽受頭痛的困擾？
en: What percentage of people suffer from migraines throughout the world?
answers: zh_tw: text: 15%
en: text: 15%

question: zh_tw: 哪個年齡層的人最常患上偏頭痛？
answers: en: text: 35 to 45 years

context: zh_tw: 隨著年齡增長，偏頭痛發病率的變化很大：偏頭痛的初次發病年齡常在 15 歲至 24 歲之間，這些患者在其 35 歲至 45 歲間的發作頻率最高。約有 1.7% 的 7 歲兒童和 3.9% 的 7 歲到 15 歲兒童患有偏頭痛，在青春期前，偏頭痛在男孩中略多見一些。在青少年中，偏頭痛在女性中的發病率要高一些，這種情況會隨著年齡增長一直持續下去，到老年時，女性的發病率甚至達到了男性的兩倍。在女性偏頭痛患者中，無先兆偏頭痛較有先兆偏頭痛更為常見，而這兩種型別偏頭痛在男性中的發病率幾乎相同。女性在圍絕經期症狀常常會加重，但隨著年齡增長會有所減輕。雖然約三分之二的老年人症狀會消失，但仍有 3-10% 的老年患者症狀會持續下去。
qas: question: zh_tw: 哪個年齡層的人最常患上偏頭痛？
en: What age range of people experience migraines most frequently?
answers: zh_tw: text: 35 歲至 45 歲

context: zh_tw: 大約在公元前 1200 年的古埃及埃伯斯紙草文稿一書中就出現了符合偏頭痛症狀的早期描述。在公元前 200 年，希波克拉底醫學院的著作描述了在頭痛前出現的視覺先兆以及嘔吐可使症狀得到部分緩解。公元二世紀，卡帕多細亞的阿雷提烏斯提出將頭痛分為三種類型：cephalalgia、cephalea 及 heterocrania。隨後，帕加馬王國的蓋倫使用了術語 hemicrania（半個腦袋），由此最終衍生出詞語偏頭痛（migraine）；他還提出，這種疼痛產生於腦膜和頭部血管。1887 年，法國一位叫做路易斯・亞森特・托馬斯的圖書管理員首次提出將偏頭痛分為兩種型別 —— 有先兆偏頭痛（migraine ophthalmique）和無先兆偏頭痛（migraine vulgaire）。環鋸術（在人的顱骨上鑽孔）早在公元前 7000 年就開始盛行。雖然有些人活了下來，但很多人都因感染而死於此手術。當時人們認為這種手術是有療效的，因為它能 “讓惡鬼消失”。17 世紀時，威廉・哈維建議將環鋸術作為偏頭痛的一種治療方法。雖然人們嘗試了多種治療偏頭痛的方法，但直到 1868 年才出現了一種最終被證明確有療效的物質 —— 這種物質便是麥角菌。1918 年，科學家從麥角菌中分離出了麥角胺。二甲麥角新鹼研發於 1959 年，隨後在 1988 年，曲坦類的第一個藥物 —— 舒馬曲坦也研發成功。在 20 世紀，隨著對疾病的研究設計的發展，科學家逐漸發現並證實各種可有效預防偏頭痛的措施。
en: Trepanation, the deliberate drilling of holes into a skull, was practiced as early as 7,000 BCE. While sometimes people survived, many would have died from the procedure due to infection. It was believed to work via "letting evil spirits escape". William Harvey recommended trepanation as a treatment for migraines in the 17th century.While many treatments for migraines have been attempted, it was not until 1868 that use of a substance which eventually turned out to be effective began. This substance was the fungus ergot from which ergotamine was isolated in 1918. Methysergide was developed in 1959 and the first triptan, sumatriptan, was developed in 1988. During the 20th century with better study design effective preventative measures were found and confirmed.
qas: question: zh_tw: 許多接受過鑽孔手術的人的死亡原因是什麼？
en: What was the cause of death of many who underwent the process known as trepenation?
answers: zh_tw: text: 感染
en: text: infection

question: zh_tw: 偏頭痛的單詞 migraine 的來源是？
en: How did the word migraine come to be?
answers: zh_tw: text: hemicrania（半個腦袋）

context: zh_tw: 偏頭痛是產生醫療費用和造成勞動力損失是一個重要原因。據估計，在歐盟國家中，偏頭痛是花費最高的神經系統疾病，每年的治療相關費用超過 270 億歐元。在美國，治療偏頭痛產生的直接費用估計高達 170 億美元；這些費用中近十分之一用在了曲坦類藥物上。而偏頭痛造成的間接損失約為 150 億美元，其中誤工帶來的損失所佔比例最大。即使是那些願意帶病工作的人，其工作效率也降低了約三分之一。此外，偏頭痛常常對患者的家庭也會產生負面影響。
en: Migraines are a significant source of both medical costs and lost productivity. It has been estimated that they are the most costly neurological disorder in the European Community, costing more than €27 billion per year. In the United States direct costs have been estimated at $17 billion while indirect costs, such as missed or decreased ability to work is estimated at $15 billion. Nearly a tenth of the direct cost is due to the cost of triptans. In those who do attend work with a migraine, effectiveness is decreased by around a third. Negative impacts also frequently occur for a person's family.
qas: question: zh_tw: 偏頭痛的影響是什麼？
en: What are the effects of migraines?
answers: zh_tw: text: 產生醫療費用和造成勞動力損失
en: text: medical costs and lost productivity

question: zh_tw: 哪些費用在美國更高？
en: Which costs are greater in the United States?
answers: zh_tw: text: 直接費用
en: text: direct costs

context: en: An early description consistent with migraines is contained in the Ebers papyrus, written around 1500 BCE in ancient Egypt. In 200 BCE, writings from the Hippocratic school of medicine described the visual aura that can precede the headache and a partial relief occurring through vomiting.A second-century description by Aretaeus of Cappadocia divided headaches into three types: cephalalgia, cephalea, and heterocrania. Galen of Pergamon used the term hemicrania (half-head), from which the word migraine was eventually derived. He also proposed that the pain arose from the meninges and blood vessels of the head. Migraines were first divided into the two now used types – migraine with aura (migraine ophthalmique) and migraine without aura (migraine vulgaire) in 1887 by Louis Hyacinthe Thomas, a French Librarian.
qas: question: zh_tw: 偏頭痛的單詞 migraine 的來源是？
answers: en: text: hemicrania (half-head)

context: en: The underlying causes of migraines are unknown. However, they are believed to be related to a mix of environmental and genetic factors. They run in families in about two-thirds of cases and rarely occur due to a single gene defect. While migraines were once believed to be more common in those of high intelligence, this does not appear to be true. A number of psychological conditions are associated, including depression, anxiety, and bipolar disorder, as are many biological events or triggers.
qas: question: zh_tw: 導致偏頭痛的原因是什麼？
answers: en: text: a mix of environmental and genetic factors

question: zh_tw: 對於偏頭痛，曾經有什麼認識？
answers: en: text: more common in those of high intelligence

context: en: There are three main aspects of treatment: trigger avoidance, acute symptomatic control, and medication for prevention. Medications are more effective if used earlier in an attack. The frequent use of medications may result in medication overuse headache, in which the headaches become more severe and more frequent. This may occur with triptans, ergotamines, and analgesics, especially opioid analgesics. Due to these concerns simple analgesics are recommended to be used less than three days per week at most.
qas: question: zh_tw: 大量用藥會增加哪種症狀？
answers: en: text: headache

question: zh_tw: 什麼時候使用藥物有最佳效果？
answers: en: text: earlier in an attack