Battistella P A, Fiumana E, Binelli M, Bertossi E, Battista P, Perakis E, Soriani S
Department of Paediatrics, University of Padova, Padova, Italy.
Cephalalgia. 2006 Feb;26(2):162-71. doi: 10.1111/j.1468-2982.2005.01008.x.
Although headache frequency is increasing in preschool age children, an extensive evaluation of the clinical features in affected patients has yet to be achieved. This retrospective study examined 243 patients who were separately analysed in two distinct groups according to the age of onset and the age of first clinical evaluation. Group 1 included preschool age children, while Group 2 consisted of pubertal age patients. In all the patients the importance of a positive family history for headache as a risk factor was confirmed. In addition, when compared with Group 2, Group 1 showed greater male gender prevalence and earlier onset of the attacks. Regarding clinical features, in Group 1, compared with Group 2, the attack duration was shorter with lower symptom association such as photo- or phonophobia, nausea and no pain increase during physical activity. In the same group, tension-type headache was the predominant diagnosis, in contrast to the high migraine prevalence of Group 2. This study also showed that the International Headache Society 1988 classification criteria are not fully adequate for juvenile headaches. In fact, the headaches of more than 10% of patients in Group 1 still remained unclassifiable, while those of all the subjects in Group 2 were properly classifiable.
尽管学龄前儿童头痛的发生率在上升，但尚未对受影响患者的临床特征进行全面评估。这项回顾性研究检查了243例患者，根据发病年龄和首次临床评估年龄将其分为两个不同的组进行分析。第1组包括学龄前儿童，第2组由青春期患者组成。在所有患者中，头痛阳性家族史作为危险因素的重要性得到了证实。此外，与第2组相比，第1组男性患病率更高，发作更早。关于临床特征，在第1组中，与第2组相比，发作持续时间较短，症状关联较少，如畏光或畏声、恶心，且体力活动时疼痛不加重。在同一组中，紧张型头痛是主要诊断，这与第2组偏头痛患病率高形成对比。这项研究还表明，国际头痛协会1988年的分类标准并不完全适用于青少年头痛。事实上，第1组中超过10%的患者的头痛仍无法分类，而第2组所有受试者的头痛都能正确分类。
