Annequin D, Tourniaire B, Dumas C
Unité fonctionnelle d'analgésie pédiatrique, hôpital d'enfants Armand-Tousseau, Paris, France.
Arch Pediatr. 2000 Sep;7(9):985-90. doi: 10.1016/s0929-693x(00)90016-2.
Although migraine is the main chronic headache in childhood and adolescence, it remains extensively misdiagnosed. Schematically, migraine is a severe headache evolving by stereotyped attacks frequently associated with marked digestive symptoms (nausea, vomiting, abdominal pain). Throbbing pain, sensitivity to sound, and light (and sometimes odors) are frequent additional symptoms. The attack is sometimes preceded by a visual or sensory aura. Rest brings relief, and sleep often ends the attack. Childhood migraine prevalence varies between 5 and 10%. Migraine episodes are frequently triggered by several factors: emotional stress (school pressure, vexation, excitement, upset), hypoglycemia, lack or excess of sleep (weekend migraine), sensory stimulation (loud noise, bright light, strong odor, heat or cold, etc.), sympathetic stimulation (sport, physical exercise). Attack treatments must be given at an early stage, oral ibuprofen (10 mg/kg) being particularly recommended. If the oral route is not available because of nausea or vomiting, rectal or nasal routes have then to be used. Non-pharmacological treatments (biofeedback and interventions combining progressive muscle relaxation) have demonstrated good efficacy as prophylactic measures. Daily prophylactic pharmacological treatments are prescribed as the second line after failure of non-pharmacological treatments.
尽管偏头痛是儿童和青少年时期主要的慢性头痛疾病，但它仍被广泛误诊。概括来说，偏头痛是一种严重的头痛，以刻板发作的形式演变，常伴有明显的消化系统症状（恶心、呕吐、腹痛）。搏动性疼痛、对声音和光线（有时还有气味）敏感是常见的附加症状。发作有时会先出现视觉或感觉先兆。休息可缓解症状，睡眠常常能结束发作。儿童偏头痛的患病率在5%至10%之间。偏头痛发作常常由多种因素触发：情绪压力（学业压力、烦恼、兴奋、心烦）、低血糖、睡眠不足或过多（周末偏头痛）、感觉刺激（噪音、强光、强烈气味、热或冷等）、交感神经刺激（运动、体育锻炼）。发作治疗必须在早期进行，特别推荐口服布洛芬（10毫克/千克）。如果因恶心或呕吐无法采用口服途径，那么就得使用直肠或鼻腔途径。非药物治疗（生物反馈以及结合渐进性肌肉松弛的干预措施）作为预防措施已显示出良好疗效。在非药物治疗失败后，每日预防性药物治疗作为二线治疗方案使用。
