Durá Travé T, Yoldi Petri M E
Unidad de Neuropediatría, Hospital Virgen del Camino, Pamplona, Spain.
An Pediatr (Barc). 2005 Feb;62(2):141-6. doi: 10.1157/13071311.
To analyze the epidemiological and clinical characteristics of migraine and tension-type headache in the pediatric age group with the aim of facilitating their differential diagnosis in clinical practice.
Information on epidemiological and clinical characteristics, physical examination and complementary examinations, if performed, was collected from the medical records of 225 children with acute recurrent headache. The criteria defined by the International Headache Society (IHS) were used in the diagnosis.
A total of 98.2 % of the patients had primary headache: migraine (48.9 %), tension-type headache (48.4 %) and mixed (0.9 %). Thirty percent of those with migraine had migraine with aura. The mean age at onset was 8.6 6 2.9 years in migraine and 9.7 6 2.5 years in tension-type headache (p < 0.05), with no differences between sexes. Children with tension-type headache showed a greater prevalence (p < 0.05) of female sex, urban origin and excellent academic performance. Children with migraine had a greater prevalence (p < 0.05) of positive family history. Migraine headaches were unilateral (44.1 %) or bilateral (55.9 %), pulsating (77.1 %), aggravated by physical activity (68.8 %), caused lost days at school (65.3 %) and were usually accompanied by vomiting (71 %) and photophobia/sonophobia (67 %). Tension-type headaches were bilateral (81.8 %) and oppressive (85.3 %), were less frequently aggravated by physical activity (11.8 %) or interrupted activities (11.8 %) and were occasionally accompanied by vomiting (7.3 %) and photophobia/sonophobia (21.8 %). Electroencephalogram and brain computed tomography scan were performed in 21 % and 39.1 % of the patients, respectively, without changing their diagnosis.
Migraine and tension-type headaches are a common cause of recurrent headache in the pediatric age group. Onset usually occurs in school-aged children. The IHS criteria for the differential diagnosis of headache in children are useful, although follow-up is the gold standard to validate diagnostic criteria.
分析儿童偏头痛和紧张型头痛的流行病学及临床特征，以便在临床实践中进行鉴别诊断。
从225例急性复发性头痛儿童的病历中收集流行病学和临床特征、体格检查及相关辅助检查（若进行了该项检查）的信息。诊断采用国际头痛协会（IHS）制定的标准。
98.2%的患者患有原发性头痛：偏头痛（48.9%）、紧张型头痛（48.4%）和混合型（0.9%）。偏头痛患者中30%为有先兆偏头痛。偏头痛的平均发病年龄为8.6±2.9岁，紧张型头痛为9.7±2.5岁（p<0.05），性别间无差异。紧张型头痛患儿女性、城市户籍及学业成绩优秀的比例更高（p<0.05）。偏头痛患儿家族史阳性的比例更高（p<0.05）。偏头痛为单侧（44.1%）或双侧（55.9%），搏动性（77.1%），因体力活动加重（68.8%），导致缺课（65.3%），通常伴有呕吐（71%）和畏光/畏声（67%）。紧张型头痛为双侧（81.8%）且有压迫感（85.3%），因体力活动加重（11.8%）或中断活动（11.8%）的情况较少见，偶尔伴有呕吐（7.3%）和畏光/畏声（21.8%）。分别有21%和39.1%的患者进行了脑电图和脑部计算机断层扫描，结果均未改变诊断。
偏头痛和紧张型头痛是儿童复发性头痛的常见原因。发病通常在学龄儿童。IHS儿童头痛鉴别诊断标准有用，不过随访是验证诊断标准的金标准。
