Cuvellier J C, Joriot S, Auvin S, Vallée L
Service de neuropédiatrie, clinique de pédiatrie, hôpital Roger-Salengro, centre hospitalier régional et universitaire de Lille, 59037 Lille cedex, France.
Arch Pediatr. 2005 Mar;12(3):316-25. doi: 10.1016/j.arcped.2004.10.012.
Migraine, according to the criteria of the International Headache Society, occurs in about 5 to 10% of children. Management of acute headache is only one of the parts of the treatment, along with identification of migraine precipitants, adjustments in lifestyle, and when necessary the use of preventive therapy, which can include non pharmacologic (relaxation or biofeedback) or pharmacologic treatment. In the acute migraine attack, a single dose of either ibuprofen 10 mg/kg or paracetamol 15 mg/kg has been shown to be effective, with only a few adverse effects. In severe migraine attacks, dihydroergotamine mesylate administered orally (20 to 40 microg/kg) or intravenously (maximum 1 mg/day) may be helpful, but there have been no large placebo-controlled trials of this treatment. Among the different triptans, it is the sumatriptan nasal spray whose efficacy has been best demonstrated. The most frequent adverse event is transitory unpleasant taste.
根据国际头痛协会的标准,偏头痛在约5%至10%的儿童中发生。急性头痛的管理只是治疗的一部分,还包括识别偏头痛的诱发因素、调整生活方式,以及在必要时使用预防性治疗,预防性治疗可包括非药物治疗(放松或生物反馈)或药物治疗。在急性偏头痛发作时,已证明单剂量布洛芬10毫克/千克或对乙酰氨基酚15毫克/千克有效,且不良反应较少。在严重偏头痛发作时,口服(20至40微克/千克)或静脉注射(最大1毫克/天)甲磺酸二氢麦角胺可能有帮助,但尚无该治疗的大型安慰剂对照试验。在不同的曲坦类药物中,舒马曲坦鼻喷雾剂的疗效得到了最充分的证明。最常见的不良事件是短暂的味觉不适。