Özge Aynur, Öksüz Nevra, Ayta Semih, Uluduz Derya, Yıldırım Veli, Toros Fevziye, Taşdelen Bahar
Department of Neurology, Mersin University School of Medicine, Mersin, Turkey.
Department of Neurology, Maltepe University School of Medicine, Istanbul, Turkey.
Pediatr Int. 2014 Dec;56(6):868-872. doi: 10.1111/ped.12381. Epub 2014 Oct 15.
The supportive clinical and pathophysiological data about the correlation between migraine and atopic disorders are far from a coincidence. In order to determine and investigate the correlates of atopic disorders in a specific dataset, we performed this retrospective cross-sectional clinical-based study.
The dataset was composed from three tertiary center web-based databases (http://www.childhoodheadache.org). Headache diagnosis and differential diagnosis were made according to the International Classification of Headache Disorders, 2nd version and the Diagnostic Statistical Manual of Mental Disorders, 5th edition. Migraine with aura, migraine without aura, chronic migraine and episodic and chronic tension type headache (TTH) patients were included. All other causes of headache disorders, including comorbid headache disorders like migraine plus TTH or "possible" causes of headache, were excluded.
The study included 438 patients with migraine and 357 patients with TTH, whose age and sex distribution were identical. After descriptive statistics accordingly, 80 migraine (18.2%) and 23 TTH (6.4%) patients were found to have specific atopic disorders (P < 0.001). Atopic disorders are more commonly reported in patients with migraine with aura (21.6%) than those with migraine without aura and TTH (P < 0.001). The most common atopic disorders were seasonal rhinitis, conjunctivitis and asthma. There was also a close correlation between TTH with atopic disorders and psychiatric comorbid disorders of the patients.
Although the International Classification of Headache Disorders, 2nd version, does not specify, atopic disorders should be suspected in all migraine patients and their relatives, not only for accurate diagnosis but also for planning prophylactic medications, such as β-blockers.
关于偏头痛与特应性疾病之间相关性的支持性临床和病理生理学数据绝非巧合。为了确定并研究特定数据集中特应性疾病的相关因素，我们开展了这项基于临床的回顾性横断面研究。
数据集由三个三级中心基于网络的数据库（http://www.childhoodheadache.org）组成。头痛的诊断和鉴别诊断依据《国际头痛疾病分类》第2版和《精神疾病诊断与统计手册》第5版进行。纳入有先兆偏头痛、无先兆偏头痛、慢性偏头痛以及发作性和慢性紧张型头痛（TTH）患者。排除所有其他头痛疾病原因，包括合并的头痛疾病如偏头痛加TTH或头痛的“可能”原因。
该研究纳入了438例偏头痛患者和357例TTH患者，他们的年龄和性别分布相同。经过相应的描述性统计，发现80例偏头痛患者（18.2%）和23例TTH患者（6.4%）患有特定的特应性疾病（P < 0.001）。有先兆偏头痛患者（21.6%）比无先兆偏头痛和TTH患者更常报告特应性疾病（P < 0.001）。最常见的特应性疾病是季节性鼻炎、结膜炎和哮喘。TTH与特应性疾病以及患者的精神共病之间也存在密切相关性。
尽管《国际头痛疾病分类》第2版未明确规定，但所有偏头痛患者及其亲属都应怀疑患有特应性疾病，这不仅有助于准确诊断，还能用于规划预防性药物治疗，如β受体阻滞剂。
