Chakravarty A, Mukherjee A, Roy D
Department of Neurology, Vivekananda Institute of Medical Sciences, 59 Beadon Street, Calcutta 700 006, India.
Cephalalgia. 2007 Oct;27(10):1109-14. doi: 10.1111/j.1468-2982.2007.01418.x. Epub 2007 Sep 10.
Literature documenting the location of pain at onset of migraine attacks and during established headaches in children and adolescents is sparse. Through a prospective study (2003-2005) of 200 children with migraine (ICHD-2: 1.1 and 1.2.1), we set out to document (i) the site of onset of pain and (ii) the location of pain during established attacks (on >50% of occasions) through semistructured interviews of patients and parents. Of the 200 children, the male:female ratio was 118 : 82 (1 : 0.69), the age range was 7-15 years (mean 11.8 years) and the duration of migraine 6 months to 4 years (mean 1.6 years). Ninety-three percent of subjects were ethnic Bengalis from the eastern Indian state of West Bengal, capital city Calcutta. Migraine types were: 1.1, 197 (98.5%); 1.2.1, three (1.5%). Location of pain at onset: 20.5% of subjects had unilateral onset; of these, 26.8% had eye pain, 65.9% frontal and 12.3% temporal pain. Thirty-three percent had bilateral location of pain, mostly bifrontal or ocular. None had vertex onset pain. However, in 35% of subjects, pain was holocranial at onset. Only 11.5% experienced pain in the occipito-cervical region at onset. Location of established headaches: in 53.7% of subjects with unilateral onset, headaches subsequently became holocranial. Hemicranial headaches occurred in only 19.5%. Of bilateral onset pains, 57.8% also became holocranial subsequently. In all, 73.5% of children ultimately experienced holocranial headaches. This study documents pain location at onset and during established headaches in children with migraine largely from a specific ethnic group.
记录儿童和青少年偏头痛发作起始时及已确诊头痛期间疼痛部位的文献稀少。通过一项针对200名偏头痛患儿（国际头痛疾病分类第二版：1.1和1.2.1）的前瞻性研究（2003 - 2005年），我们试图通过对患者及其父母进行半结构化访谈，记录（i）疼痛发作部位，以及（ii）已确诊发作期间（超过50%的发作次数）的疼痛部位。200名儿童中，男女比例为118 : 82（1 : 0.69），年龄范围为7 - 15岁（平均11.8岁），偏头痛病程为6个月至4年（平均1.6年）。93%的受试者是来自印度东部西孟加拉邦首府加尔各答的孟加拉族。偏头痛类型为：1.1型，197例（98.5%）；1.2.1型，3例（1.5%）。疼痛发作部位：20.5%的受试者疼痛单侧发作；其中，26.8%有眼部疼痛，65.9%为额部疼痛，12.3%为颞部疼痛。33%的受试者疼痛双侧发作，主要是双侧额部或眼部。无人疼痛起始于头顶。然而，35%的受试者疼痛起始时为全头部疼痛。仅11.5%的受试者起始时枕颈区疼痛。已确诊头痛的部位：单侧发作的受试者中，53.7%的头痛随后变为全头部疼痛。半侧头部头痛仅占19.5%。双侧发作疼痛的受试者中，57.8%随后也变为全头部疼痛。总体而言，73.5%的儿童最终经历全头部头痛。本研究记录了主要来自特定种族群体的偏头痛患儿疼痛发作起始时及已确诊头痛期间的疼痛部位。
