Kondev Lauren, Minster Anna
Departments of Pediatrics and Neurology, Division of Pediatric Neurology, Tufts University School of Medicine, New England Medical Center, 750 Washington Street, Box 330, Boston, MA 02111, USA.
Otolaryngol Clin North Am. 2003 Dec;36(6):1153-70. doi: 10.1016/s0030-6665(03)00123-3.
Headaches commonly affect children and adolescents. Proper diagnosis and management is dependent on thorough history taking and a comprehensive physical and neurological examination. Additional diagnostic testing is indicated in some cases. The second edition of the headache classification system by the International Headache Society has recently become available. The classification system is primarily based on adults, but we discussed the subtle distinctions made regarding children. In addition to the primary headache types of migraine, tension-type, and cluster headaches, we discussed selected symptomatic headaches. Emphasis was placed on migraine and tension-type headaches because these are the most common pediatric headache types. We briefly discussed genetic aspects of headaches. Genetic factors have been hypothesized for chronic tension headache and other forms of migraine, but genetic linkage has only been established for familial hemiplegic migraine. We reviewed the nonpharmacologic and pharmacologic therapies, including abortive and prophylactic medications for various age groups. Unlike headaches, facial neuralgias are rare in otherwise healthy children. Facial pain may be neurological, vascular, or dental in origin. We focused on trigeminal neuralgia, glossopharyngeal neuralgia, occipital neuralgia, and Bell's palsy as neurological causes of facial pain in children.
头痛在儿童和青少年中很常见。正确的诊断和管理取决于全面的病史采集以及全面的体格和神经系统检查。在某些情况下需要进行额外的诊断测试。国际头痛协会的头痛分类系统第二版最近已发布。该分类系统主要基于成人，但我们讨论了针对儿童的细微差别。除了偏头痛、紧张型头痛和丛集性头痛等原发性头痛类型外，我们还讨论了特定的症状性头痛。重点讨论了偏头痛和紧张型头痛，因为这些是最常见的儿童头痛类型。我们简要讨论了头痛的遗传方面。已经推测遗传因素与慢性紧张性头痛和其他形式的偏头痛有关，但仅在家族性偏瘫性偏头痛中建立了遗传联系。我们回顾了非药物和药物治疗方法，包括针对不同年龄组的发作期和预防性药物。与头痛不同，面部神经痛在其他方面健康的儿童中很少见。面部疼痛可能源于神经、血管或牙齿问题。我们重点关注三叉神经痛、舌咽神经痛、枕神经痛和贝尔麻痹，这些是儿童面部疼痛的神经学原因。
