Duranović Vlasta, Bosnjak Vlatka Mejaski, Lujić Lucija, Krakar Goran
Klinika za pedijatriju, Klinika za djecje bolesti Zagreb, Zagreb, Hrvatska.
Acta Med Croatica. 2008 May;62(2):241-5.
The "gold standard" in the diagnosis of pediatric migraine includes personal history, clinical and neurological examination. Many important data on previous morbidity, psychosocial status and recent sickness (today's headache) can be found by using an interview, "face to face", or by "headache diary". On clinical examination, it is important to pay due attention to cardiovascular and respiratory systems as well as to examination of the skin. Thorough neurological examination may reveal disturbances of the mental status, cranial nerves, motor and sensory systems, reflexes, coordination and visual status. Acute headache without febrile illness and neurological disturbances is very indicative on childhood migraine or "migraine variants". However, due to many secondary headaches with migraine-like symptoms, it is important to perform detailed diagnostic protocol including computerized tomography, magnetic resonance imaging, electroencephalography, transcranial color doppler, laboratory tests and toxicological screening. Neuroimaging is indicated in children with acute headache, chronic progressive headache, especially if associated with vomiting, nausea or neurological disturbances, papillary edema, and in children with personality changes, learning difficulties and those under five years of age.
小儿偏头痛诊断的“金标准”包括个人病史、临床及神经学检查。通过“面对面”访谈或“头痛日记”，可以获取许多关于既往发病率、心理社会状况及近期疾病（今日头痛情况）的重要数据。临床检查时，对心血管和呼吸系统以及皮肤检查给予应有的关注很重要。全面的神经学检查可能会发现精神状态、脑神经、运动和感觉系统、反射、协调能力及视觉状态的异常。无发热性疾病及神经功能障碍的急性头痛对儿童偏头痛或“偏头痛变异型”具有很强的指示性。然而，由于许多继发性头痛具有类似偏头痛的症状，因此进行详细的诊断方案很重要，包括计算机断层扫描、磁共振成像、脑电图、经颅彩色多普勒、实验室检查及毒理学筛查。对于有急性头痛、慢性进行性头痛的儿童，尤其是伴有呕吐、恶心或神经功能障碍、视乳头水肿的儿童，以及有性格改变、学习困难的儿童和5岁以下儿童，均需进行神经影像学检查。
