Roche Herrero M C, Arcas Martínez J, Martínez-Bermejo A, López Martín V, Polanco I, Tendero Gormaz A, Fernández Jaén A
Servicio de Neurología Infantil; Hospital Infantil La Paz, Madrid, 28046, España.
Rev Neurol. 2001;32(4):301-9.
Headache is the commonest clinical symptom during childhood and adolescence, from a neurologist s point of view. The pathophysiology of migraine and tension headache involve personality and biochemical factors, such as serotonin, which are also common in coeliac disease.
To establish the prevalence of headache in children and adolescents with coeliac disease, and any possible relation between these conditions.
We made a randomized selection of 86 patients with coeliac disease. All were on gluten-free diets and had no current gastroenterological symptoms. They had direct interviews and full physical and neurological examinations. The diagnosis of headache was based on criteria of the International Headache Society in 1988.
The average age was 12.71 +/- 4.5 years (range 5-24). Headache occurred in 34 (39.5%) of the 86 patients studied. In 18 cases (20.9%) headache was of tension type and in 16 (18.6%) of migraine type. Of the latter, 10 cases had auras and 6 did not. There was no significant sex difference.
An increased prevalence of both migraine and tension headaches was observed in the coeliac patients studied as compared with data published in the literature. In the former patients there was also a lower frequency in histories of migraine in first degree family members. This data is probably related to the personality of the patient or to his family or social circumstances in the case of tension headaches. In the case of migraine it may be due to biochemical factors such as a lowered plasma serotonin, seen both in coeliac disease and in migraine.
从神经科医生的角度来看，头痛是儿童和青少年时期最常见的临床症状。偏头痛和紧张性头痛的病理生理学涉及人格和生化因素，如血清素，而这些因素在乳糜泻中也很常见。
确定乳糜泻儿童和青少年中头痛的患病率，以及这些病症之间的任何可能关系。
我们随机选取了86例乳糜泻患者。所有患者均采用无麸质饮食，且目前没有胃肠道症状。他们接受了直接访谈以及全面的体格和神经检查。头痛的诊断基于1988年国际头痛协会的标准。
平均年龄为12.71±4.5岁（范围5 - 24岁）。在研究的86例患者中，有34例（39.5%）出现头痛。其中18例（20.9%）为紧张型头痛，16例（18.6%）为偏头痛型。在偏头痛型中，10例有先兆，6例没有。性别差异不显著。
与文献报道的数据相比，在我们研究的乳糜泻患者中，偏头痛和紧张性头痛的患病率均有所增加。在前一组患者中，一级家庭成员偏头痛病史的发生率也较低。对于紧张性头痛，这些数据可能与患者的人格或其家庭或社会环境有关。对于偏头痛，可能是由于生化因素，如在乳糜泻和偏头痛中均可见的血浆血清素降低。
