Sri-udomkajorn Somjit, Ruangsuwan Surapee
Division of Child Neurology, Queen Sirikit National Institute of Child Health, Department of Medical Service, Ministry of Pubic Health, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2008 Oct;91 Suppl 3:S104-8.
To study the short-term outcome and the factors associated with the outcome in childhood tension type and migraine headache patients.
Children aged 16 years or less with first diagnosed of either migraine or tension-type headache were reassured the cause of headache and treated by avoiding triggering factors, taking intermittent analgesics or a daily preventive medication such as propanolol 10 mg two times a day or amitriptyline 10 mg at night for patients who were suffered from the frequent headache attacks whether had to stop activity or go to sleep. They were followed up at 2 weeks and 2 months to confirm the diagnosis and the response to the treatment. The short-term outcomes and the possible factors associated with the outcomes were analysed.
Pre-treatment 81% of migraine patients and 43.5% of tension-type patients were significant frequently suffered from headache attacks. Post-treatment revealed that it reduced to 4% in migraine patients and 16% tension-type patients. Gender; age at onset, severity before treatment, precipitating factors; hot weather sleep deprivation, learning stress, familial stress, night awakening, familial history of headache were not statistically significant in short-term outcomes.
Treatment childhood tension-type and migraine headache by reassurance, avoid the probably precipitating factors, intermittent analgesics and usage of amitriptyline or propanolol had good efficacy in reducing the severity of attack. The authors cannot identify the associated factor with the outcome of treatment.
研究儿童紧张型头痛和偏头痛患者的短期预后以及与预后相关的因素。
对首次诊断为偏头痛或紧张型头痛的16岁及以下儿童，告知其头痛原因，并通过避免诱发因素、服用间歇性镇痛药或每日预防性药物（如对频繁头痛发作（无论是否导致活动停止或需卧床休息）的患者，给予普萘洛尔10毫克，每日两次，或阿米替林10毫克，每晚一次）进行治疗。在2周和2个月时对他们进行随访，以确认诊断和治疗反应。分析短期预后以及与预后可能相关的因素。
治疗前，81%的偏头痛患者和43.5%的紧张型头痛患者频繁发作头痛。治疗后，偏头痛患者降至4%，紧张型头痛患者降至16%。性别、发病年龄、治疗前严重程度、诱发因素（炎热天气、睡眠剥夺、学习压力、家庭压力、夜间觉醒、头痛家族史）在短期预后中无统计学意义。
通过安慰、避免可能的诱发因素、使用间歇性镇痛药以及使用阿米替林或普萘洛尔治疗儿童紧张型头痛和偏头痛，在减轻发作严重程度方面有良好疗效。作者无法确定与治疗结果相关的因素。
