Cuvellier J-C, Riquet A, Vallée L
Service de neuropédiatrie, clinique de pédiatrie, hôpital Roger-Salengro, centre hospitalier régional et universitaire de Lille, boulevard du Professeur-Leclerq, 59037 Lille cedex, France.
Arch Pediatr. 2008 Nov;15(11):1693-9. doi: 10.1016/j.arcped.2008.07.020. Epub 2008 Sep 30.
According to the criteria of the International Headache Society, migraine occurs in approximately 5 to 10% of children. As many as 30% of young patients with migraine experience such frequent and disabling attacks, or have unsatisfactory results and/or experience adverse effects with pharmacologic treatment of acute migraine attack, that daily preventive medications are required. Many studies have investigated the use of antiepileptic drugs in this indication but there is a paucity of placebo-controlled studies. So far, in the setting of migraine with and without aura, only flunarizine and topiramate have proved their efficacy in more than one placebo-controlled study. Uncontrolled studies suggest the possible efficacy of valproic acid, gabapentin, levetiracetam, zonisamide, and magnesium in preventive therapy of childhood periodic syndromes. Most of antiepileptic drugs used in pediatric preventive therapy are well tolerated. The most common adverse events are asthenia and somnolence.
根据国际头痛协会的标准,偏头痛在约5%至10%的儿童中发生。多达30%的偏头痛年轻患者经历如此频繁且致残的发作,或在急性偏头痛发作的药物治疗中效果不佳和/或出现不良反应,以至于需要每日预防性用药。许多研究调查了抗癫痫药物在这一适应症中的应用,但缺乏安慰剂对照研究。到目前为止,在有先兆和无先兆偏头痛的情况下,只有氟桂利嗪和托吡酯在不止一项安慰剂对照研究中证明了其疗效。非对照研究表明丙戊酸、加巴喷丁、左乙拉西坦、唑尼沙胺和镁在儿童周期性综合征预防性治疗中可能有效。儿科预防性治疗中使用的大多数抗癫痫药物耐受性良好。最常见的不良事件是乏力和嗜睡。