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儿童无先兆偏头痛的诊断标准。

Diagnostic criteria of pediatric migraine without aura.

作者信息

Senbil Nesrin, Gürer Yahya Kemal Yavuz, Aydin Omer Faruk, Rezaki Bengii, Inan Levent

机构信息

Department of Pediatric Neurology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.

出版信息

Turk J Pediatr. 2006 Jan-Mar;48(1):31-7.

Abstract

The objectives of this study were to assess the validity of the International Classification of Headache Disorders-I (ICHD-I) and the International Headache Society-Revised (IHS-R) criteria and to evaluate the other headache features that are not included in these criteria for migraine without aura in the pediatric population. One hundred and thirty-two children who referred to our clinic with the complaint of chronic or recurrent headache were evaluated. Clinical diagnosis of the pediatric neurologist was used as the gold standard in evaluating the validity of ICHD-I and IHS-R criteria and the other headache features. After eliminating patients with other migraine types, secondary headache, and missing data, 92 patients were included in the study according to their records. Sixty-one children (66.3%) were diagnosed as migraine without aura. Using the clinical diagnosis as the gold standard, the specificity of ICHD-I criteria was detected as 93.5%, while the sensitivity was detected as 36.1%. IHS-R criteria had 90.3% specificity and 78.7% sensitivity. Relief of headache with sleeping or lying down in a dark, quiet room was found to be the highest specific and sensitive factor of the other headache features not included in these criteria. IHS-R criteria were found to be more valid in the diagnosis of migraine without aura than ICHD-I criteria. IHS-R criteria are recommended both in clinical practice and in the studies requiring migraine without aura case definitions in the pediatric population.

摘要

本研究的目的是评估《国际头痛疾病分类第一版》(ICHD-I)和《国际头痛协会修订版》(IHS-R)标准的有效性,并评估这些标准未涵盖的小儿无先兆偏头痛的其他头痛特征。对132名因慢性或复发性头痛主诉前来我院就诊的儿童进行了评估。在评估ICHD-I和IHS-R标准以及其他头痛特征的有效性时,以儿科神经科医生的临床诊断作为金标准。在排除其他偏头痛类型、继发性头痛和缺失数据的患者后,根据记录,92名患者被纳入研究。61名儿童(66.3%)被诊断为无先兆偏头痛。以临床诊断作为金标准,ICHD-I标准的特异性为93.5%,而敏感性为36.1%。IHS-R标准的特异性为90.3%,敏感性为78.7%。发现在黑暗、安静的房间里睡觉或躺下后头痛缓解是这些标准未涵盖的其他头痛特征中特异性和敏感性最高的因素。发现IHS-R标准在小儿无先兆偏头痛的诊断中比ICHD-I标准更有效。在临床实践以及需要小儿无先兆偏头痛病例定义的研究中,均推荐使用IHS-R标准。

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