Headache Science Center and Department of Child Neurology and Psychiatry, IRCCS C. Mondino National Institute of Neurology Foundation, Pavia, Italy.
Med Hypotheses. 2011 Jun;76(6):778-81. doi: 10.1016/j.mehy.2011.02.016. Epub 2011 Feb 26.
Migraine is a neurological disorder characterized by unilateral head pain, nausea and/or vomiting and altered sensory perception (particularly phono- and/or photophobia). It is a common and disabling condition in children and adolescents, just as it is in adults; its origins, pathophysiology and long-term course are still not fully understood. Biological factors are currently held to be crucial in the aetiopathogenesis of primary headaches, such as migraine. In children and adolescents, we hypothesize that for migraine to develop, life events and their psychological processing are fundamental and can act in two different ways: either as a predisposing factor, inducing a chronic state of anxiety or depression (even subclinical), or as a trigger factor, activating a cascade of psychological events which, in turn, activate the biological mechanisms that produce the migraine attack. According to our hypothesis, psychological processing of life events (i.e. how the child perceives and mentally processes them) is the main factor in migraine aetiopathogenesis. This hypothesis has important implications in terms of diagnostic and therapeutic choices for children and adolescents with migraine.
偏头痛是一种以单侧头痛、恶心和/或呕吐以及感觉知觉改变（尤其是对声音和/或光线敏感）为特征的神经系统疾病。偏头痛在儿童和青少年中与在成年人中一样常见且会导致残疾；其病因、病理生理学和长期病程仍不完全清楚。目前认为，生物因素对于偏头痛等原发性头痛的发病机制至关重要。在儿童和青少年中，我们假设为了偏头痛的发展，生活事件及其心理处理是基本的，并且可以以两种不同的方式发挥作用：要么作为一个促成因素，导致慢性焦虑或抑郁（甚至是亚临床）状态，要么作为一个触发因素，激活一连串的心理事件，进而激活产生偏头痛发作的生物学机制。根据我们的假设，生活事件的心理处理（即儿童如何感知和在心理上处理它们）是偏头痛发病机制的主要因素。对于偏头痛患儿和青少年，这一假设对诊断和治疗选择具有重要意义。
