Cai Shayne, Hamiwka Lorie D, Wirrell Elaine C
Department of Biomedical Sciences, University of Calgary, Calgary, Alberta, Canada.
Pediatr Neurol. 2008 Aug;39(2):91-6. doi: 10.1016/j.pediatrneurol.2008.05.012.
Structured interviews regarding peri-ictal headaches and personal or family histories of interictal headaches were conducted on 101 children (aged 5-18 years), with generalized tonic-clonic or partial seizures. Epilepsy-specific details were collected by interviews and reviews of neurology clinic charts. Peri-ictal headaches were reported by 41% (29%, postictal only; 5%, preictal only; 7%, both). Clear migrainous features were present in 50% of preictal and 58% of postictal headaches. Most children described bilateral headaches. No demographic or epilepsy-specific correlates were identified that predicted peri-ictal headaches. Interictal headaches occurred in 24%, with 14% of children meeting criteria for migraines. However, neither interictal migraines nor a positive family history of migraines was significantly predictive of either peri-ictal headaches or migrainous peri-ictal headaches. Postictal headaches occurred reliably after most seizures in predisposed children, and interrupted activities in the majority. Whereas only half of children received abortive medications for these headaches, simple analgesics were effective in most cases. We conclude that peri-ictal headaches are common, affecting 41% of children with epilepsy. Their presence should be routinely queried, and if documented, treatment with simple analgesics appears beneficial and should be considered.
我们对101名患有全身性强直阵挛发作或部分性发作的儿童（年龄在5至18岁之间）进行了关于发作期头痛以及发作间期头痛的个人或家族病史的结构化访谈。通过访谈和查阅神经科门诊病历收集了癫痫的具体细节。41%的儿童报告有发作期头痛（仅发作后头痛的占29%；仅发作前头痛的占5%；发作前和发作后均有的占7%）。50%的发作前头痛和58%的发作后头痛具有明显的偏头痛特征。大多数儿童描述为双侧头痛。未发现可预测发作期头痛的人口统计学或癫痫特异性相关因素。24%的儿童有发作间期头痛，其中14%的儿童符合偏头痛标准。然而，发作间期偏头痛或偏头痛家族史均不能显著预测发作期头痛或具有偏头痛特征的发作期头痛。在易患发作后头痛的儿童中，大多数发作后会可靠地出现头痛，且大多数会干扰活动。虽然只有一半的儿童针对这些头痛使用了终止发作药物，但在大多数情况下，简单的镇痛药是有效的。我们得出结论，发作期头痛很常见，影响了41%的癫痫儿童。应常规询问是否存在发作期头痛，如果有记录，使用简单镇痛药治疗似乎有益，应予以考虑。
