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[儿童和青少年慢性每日头痛]

[Chronic daily headache in children and adolescents].

作者信息

Cuvellier J-C, Cuisset J-M, Vallée L

机构信息

Service de neuropédiatrie, clinique de pédiatrie, hôpital Roger-Salengro, CHRU de Lille, boulevard du Professeur-Leclerq, 59037 Lille cedex, France.

出版信息

Arch Pediatr. 2008 Dec;15(12):1805-14. doi: 10.1016/j.arcped.2008.09.017. Epub 2008 Nov 1.

Abstract

Chronic daily headache (CDH) affects 2-4% of adolescent females and 0.8-2% of adolescent males. Chronic daily headache is diagnosed when headaches occur more than 4h/day, 15 headache days per month or more, over a period of 3 consecutive months, without an underlying pathology. It is manifested by severe intermittent, migraine-like headaches as well as by chronic baseline headaches. Both Silberstein-Lipton criteria and the second edition of the International Classification of Headache Disorders (ICHD) can be used to classify chronic daily headache in children and adolescents. Chronic daily headache is classified into four diagnostic categories: transformed (Silberstein-Lipton criteria)/chronic (ICHD) migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Children and adolescents with chronic daily headache frequently have sleep disturbance, pain at other sites, dizziness, medication-overuse headache, and a psychiatric comorbidity (anxiety and mood disorders). Chronic daily headache frequently results in school absence. Successful approaches to treatment include reassurance, education, use of preventative medication, avoidance of analgesics, and helping the child return to a functional daily routine and a regular school schedule.

摘要

慢性每日头痛(CDH)影响2% - 4%的青春期女性和0.8% - 2%的青春期男性。当头痛每天发作超过4小时、每月头痛天数达15天或更多,且持续3个连续月,同时无潜在病理状况时,可诊断为慢性每日头痛。其表现为严重的间歇性、类似偏头痛的头痛以及慢性基线头痛。西尔伯斯坦 - 利普顿标准和《国际头痛疾病分类》(ICHD)第二版均可用于对儿童和青少年的慢性每日头痛进行分类。慢性每日头痛分为四个诊断类别:转化型(西尔伯斯坦 - 利普顿标准)/慢性(ICHD)偏头痛、慢性紧张型头痛、新发性每日持续性头痛和持续性偏侧头痛。患有慢性每日头痛的儿童和青少年经常出现睡眠障碍、其他部位疼痛、头晕、药物过量使用性头痛以及精神共病(焦虑和情绪障碍)。慢性每日头痛常导致缺课。成功的治疗方法包括安慰、教育、使用预防性药物、避免使用镇痛药,以及帮助孩子恢复正常的日常生活和规律的上学日程。

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