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儿童偏头痛使用 ICHD-3β标准诊断的先兆特征。

Features of aura in paediatric migraine diagnosed using the ICHD 3 beta criteria.

机构信息

1 Headache Centre, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.

2 Department of Pediatrics, Belcolle Hospital, Viterbo, Italy.

出版信息

Cephalalgia. 2018 Oct;38(11):1742-1747. doi: 10.1177/0333102417748571. Epub 2017 Dec 14.

Abstract

Background In children and adolescents, the prevalence rate of migraine with aura is 1.6%. Few studies concerning migraine with aura features in paediatric population have been reported. Aim The aim of our study was to investigate clinical features of aura in a retrospective cohort of children with migraine with aura. Furthermore, we studied whether the International Classification of Headache Disorder (ICHD) 3 beta version criteria could efficiently detect migraine with aura in a paediatric population. Results We included 164 patients who experienced aura associated with headache (mean age 9.92 ± 2.64 years). When the ICHD-II criteria were used, a final diagnosis of migraine with typical aura was obtained in 15.3% of patients, probable migraine with typical aura in 13.4%, and typical aura with headache in 61.8%, while in in 9.5% of patients the diagnosis was undetermined. According to ICHD-3 beta, we diagnosed migraine with typical aura in 77.7% of patients, probable migraine with typical aura in 13.4%, and an undetermined diagnosis in 9.5% (less than two attacks). Conclusion Aura features did not depend on age and were similar to those of adults. However, the headache could be difficult to classify if headache duration was considered. In this view, the ICHD-3 beta offers the advantage of not considering headache features, including pain duration, for the diagnosis of migraine with typical aura, thus making this diagnosis easier in children and adolescents.

摘要

背景

在儿童和青少年中,有先兆偏头痛的患病率为 1.6%。目前已有一些关于儿科人群中偏头痛先兆特征的研究。目的:本研究旨在调查偏头痛伴先兆患儿的先兆临床特征。此外,我们还研究了国际头痛疾病分类(ICHD)第 3 版β能否有效地检测儿科人群中的偏头痛伴先兆。结果:我们纳入了 164 例伴有头痛的先兆患者(平均年龄 9.92±2.64 岁)。当使用 ICHD-II 标准时,15.3%的患者被诊断为典型偏头痛伴先兆,13.4%的患者被诊断为可能的典型偏头痛伴先兆,61.8%的患者被诊断为典型先兆伴头痛,而 9.5%的患者诊断不确定。根据 ICHD-3β,我们诊断出 77.7%的患者为典型偏头痛伴先兆,13.4%的患者为可能的典型偏头痛伴先兆,9.5%(少于 2 次发作)的患者诊断不确定。结论:先兆特征不依赖于年龄,与成人相似。然而,如果考虑头痛持续时间,则头痛的分类可能会很困难。在这方面,ICHD-3β 的优势在于不考虑头痛特征,包括疼痛持续时间,用于诊断典型偏头痛伴先兆,从而使儿童和青少年更容易做出诊断。

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