Anttila Pirjo
Child and Adolescent Health Care Unit, Turku City Hospital, Linnankatu 28, 20100 Turku, Finland.
Lancet Neurol. 2006 Mar;5(3):268-74. doi: 10.1016/S1474-4422(06)70376-3.
The prevalence of non-migrainous headache is 10-25% in childhood and adolescence. Although tension-type headache and migraine are the two most common types of headache in children and adolescents, most articles address migraine headache. The distinction of tension-type headache from migraine can be difficult; use of The International Classification of Headache Disorders criteria helps. However, these criteria might be too restrictive to differentiate tension-type headache from migraine without aura in children. The pathophysiology of tension-type headache is largely unknown. The smaller genetic effect on tension-type headache than on migraine suggests that the two disorders are distinct. However, many believe that tension-type headache and migraine represent the same pathophysiological spectrum. Some indications of effective treatment exist. For children with frequent headache, the antidepressant amitriptyline might be beneficial for prophylaxis, although no placebo-controlled studies have been done. Restricted studies have suggested the efficacy of psychological and cognitive behavioural approaches in the treatment of childhood tension-type headache.
在儿童和青少年中，非偏头痛性头痛的患病率为10%至25%。尽管紧张型头痛和偏头痛是儿童和青少年中最常见的两种头痛类型，但大多数文章讨论的是偏头痛。区分紧张型头痛和偏头痛可能很困难；使用《国际头痛疾病分类》标准会有所帮助。然而，这些标准可能过于严格，难以区分儿童紧张型头痛和无先兆偏头痛。紧张型头痛的病理生理学在很大程度上尚不清楚。与偏头痛相比，遗传因素对紧张型头痛的影响较小，这表明这两种疾病是不同的。然而，许多人认为紧张型头痛和偏头痛代表相同的病理生理谱。存在一些有效治疗的迹象。对于经常头痛的儿童，抗抑郁药阿米替林可能对预防有益，尽管尚未进行安慰剂对照研究。有限的研究表明心理和认知行为方法在治疗儿童紧张型头痛方面具有疗效。
