Özge Aynur, Uluduz Derya, Bolay Hayrunnisa
aAlgology and Clinical Neurophysiology, Department of Neurology, Mersin University School of Medicine, Mersin bNeurology Department, Istanbul University, Cerrahpasa School of Medicine, Istanbul cDepartment of Neurology and Algology, Gazi University, Neuropsychiatry Centre, Ankara, Turkey.
Curr Opin Neurol. 2017 Jun;30(3):287-291. doi: 10.1097/WCO.0000000000000439.
To clarify the causal relationship between migraine and atopic disorders in children and adolescents.
Migraine headache and atopic disorders including asthma are both common functional syndromes of childhood in which nature of the relationship is still debated. Attacks may induce in both disorders upon exposure to potential triggers in genetically susceptible individuals. Clinical phenotype manifests by temporary dysfunction of target tissue mediated by inflammation triggered by specific agents. Clinical features also change after puberty because of the partial effect of female sex hormones on the process. Appropriate definition of the syndrome and differentiating from other disorders are necessary not only for correct diagnosis, but also for planning of management strategies in children. Allergic rhinosinusitis needs to be differentiated from migraine even in experienced clinics. Questioning the presence of cranial autonomic symptoms is important clue in the differential diagnosis. Atopic disorder screening is particularly required in the diagnosis of migraine in childhood and adolescents. The link between both disorders of childhood seems to be far from a coincidence and some common inflammatory mechanisms are shared.
On the basis of clinical features, laboratory findings and some practical clues in children, accurate diagnosis of migraine and atopic disorders are very critical for physicians, pediatricians and algologists.
阐明儿童和青少年偏头痛与特应性疾病之间的因果关系。
偏头痛和包括哮喘在内的特应性疾病都是儿童期常见的功能性综合征，二者关系的本质仍存在争议。在基因易感性个体中，暴露于潜在触发因素时，两种疾病都可能引发发作。临床表型表现为特定因素触发炎症介导的靶组织暂时性功能障碍。由于女性性激素对该过程有部分影响，青春期后临床特征也会发生变化。正确定义综合征并与其他疾病相鉴别，不仅对正确诊断很有必要，对制定儿童管理策略也很重要。即使在经验丰富的诊所，变应性鼻-鼻窦炎也需要与偏头痛相鉴别。询问是否存在头颅自主神经症状是鉴别诊断的重要线索。在儿童和青少年偏头痛的诊断中，尤其需要进行特应性疾病筛查。儿童期这两种疾病之间的联系似乎并非巧合，存在一些共同的炎症机制。
基于儿童的临床特征、实验室检查结果及一些实用线索，准确诊断偏头痛和特应性疾病对内科医生、儿科医生和疼痛科医生而言至关重要。
