Rossi L N, Cortinovis I, Menegazzo L, Brunelli G, Bossi A, Macchi M
Pediatric Department, Institute of Biometry and Medical Statistics, University of Milan, Italy.
Dev Med Child Neurol. 2001 Jan;43(1):45-51. doi: 10.1017/s001216220100007x.
The International Headache Society (IHS) classification system (1988) was developed primarily for headache disorders in adults and its validity for paediatric age is currently under discussion; in 1995 Seshia et al. proposed a revision of the criteria for migraine without aura to make diagnostic criteria more applicable to children. The purposes of the current study were to: (1) compare the IHS classification with the Seshia proposal, (2) compare the children affected by migraine without aura (MO) with the children affected by tension headache (TH) as defined by Seshia, for characteristics which are not included in the classification. The patients are a series of 320 children (mean age 9.9, SD 2.6 years; 144 males, 176 females) with recurrent or chronic headaches referred to a headache clinic in Milan, Italy. Using the Seshia criteria instead of the IHS criteria a higher number of children were included in the MO category: bilateral pain and family history of migraine were the most important factors which allowed a shift of children into this category. However, with the Seshia classification there was no reduction in the number of unclassifiable children. The reason why some children could not be classified was a short duration of attacks; the majority of unclassifiable children were 6 years old or less. No relevant difference was found between children with MO and children with TH for the following variables: occurrence of attacks in the afternoon or evening after school, reduction of attacks during school holidays, full-time schooling, after-school activities on school days, disordered daily life. On the contrary children with MO when compared with those with TH showed a higher number of precipitating factors and for the following factors a significant difference was found: exposure to TV or a computer, sleep deficiency, and strong emotions. Furthermore, children with MO showed a greater severity of attacks.
国际头痛协会（IHS）分类系统（1988年）主要是针对成人头痛疾病制定的，其在儿童年龄段的有效性目前正在讨论中；1995年，塞西亚等人提议修订无先兆偏头痛的标准，以使诊断标准更适用于儿童。本研究的目的是：（1）将IHS分类与塞西亚的提议进行比较，（2）比较无先兆偏头痛（MO）患儿与塞西亚定义的紧张性头痛（TH）患儿在分类中未包含的特征。患者为320名患有复发性或慢性头痛的儿童（平均年龄9.9岁，标准差2.6岁；男性144名，女性176名），他们被转诊至意大利米兰的一家头痛诊所。使用塞西亚标准而非IHS标准时，MO类别中纳入的儿童数量更多：双侧疼痛和偏头痛家族史是使儿童转入该类别的最重要因素。然而，采用塞西亚分类法时，无法分类的儿童数量并未减少。一些儿童无法分类的原因是发作持续时间短；大多数无法分类的儿童年龄在6岁及以下。在以下变量方面，MO患儿和TH患儿之间未发现相关差异：放学后下午或晚上发作、学校假期发作减少、全日制上学、上学日的课后活动、日常生活紊乱。相反，与TH患儿相比，MO患儿的诱发因素更多，并且在以下因素方面存在显著差异：接触电视或电脑、睡眠不足和强烈情绪。此外，MO患儿的发作严重程度更高。
