Child Neurology, Headache Paediatric Center, Paediatric Sleep Centre, Chair of Pediatrics, II Faculty of Medicine, Sapienza University, c/o Sant'Andrea Hospital, Rome, Italy.
Acta Paediatr. 2011 Apr;100(4):491-5. doi: 10.1111/j.1651-2227.2010.02115.x. Epub 2011 Jan 12.
The aim of this paper is to review the main topics about the management of paediatric tension-type headache. A Medline search was undertaken of all reports and reviews published between 1990 and 2010 using MeSH search terms 'tension-type headache (TTH), 'treatment' and 'children'. TTH is a very common disorder in childhood and adolescents. In many cases, the frequency and intensity of episodes may be likely to interfere with school and social activities. For this reason, a correct diagnosis and appropriate management of TTH are essential. A detailed history and proper examination, as well as a headache diary, are essential for this purpose and help to distinguish secondary causes of headache. Lacking are studies to test the efficacy and safety of pharmacological treatment in children, and a few well-tested drugs are available for this purpose. To date, relaxation techniques and biofeedback are therefore best placed as the first-line therapies.
A thorough evaluation of headache in paediatric age is necessary to make a correct diagnosis and start the appropriate treatment. In particular, an appropriate management requires an individually tailored strategy which should include both pharmacological and nonpharmacological therapies. New treatment options for elderly patients with headache including acute, prophylactic and interventional techniques are needed.
本文的目的是回顾儿科紧张型头痛管理的主要议题。使用 MeSH 搜索词“紧张型头痛(TTH)”、“治疗”和“儿童”,对 1990 年至 2010 年间发表的所有报告和综述进行了 Medline 检索。TTH 是儿童和青少年中非常常见的疾病。在许多情况下,发作的频率和强度可能会干扰学校和社会活动。因此,正确的诊断和适当的 TTH 管理是必不可少的。详细的病史和适当的检查,以及头痛日记,对于这一点是必不可少的,并有助于区分头痛的继发性原因。缺乏测试儿童药物治疗疗效和安全性的研究,为此目的仅有少数经过充分测试的药物可用。迄今为止,放松技术和生物反馈是作为一线治疗的最佳选择。
对儿科年龄的头痛进行彻底评估对于做出正确的诊断和开始适当的治疗是必要的。特别是,适当的管理需要一个个性化的策略,其中应包括药物和非药物治疗。需要为老年头痛患者提供新的治疗选择,包括急性、预防性和介入性技术。