Khrizman Marina, Pakalnis Ann
Pediatr Ann. 2018 Feb 1;47(2):e55-e60. doi: 10.3928/19382359-20180129-02.
Migraine is one of the most common neurologic conditions in pediatrics. It can be a significant stressor, causing absences from school and interruption of parents' work and family schedules. The mainstay of treatment remains educating patients about healthy lifestyle practices and the influences of sleep, stressors, and hydration on triggering migraine attacks. Psychological therapies such as biofeedback or cognitive-behavioral therapy may be beneficial in some patients, especially those with prominent psychological comorbidities. New advances in the pathophysiology of migraine and additional pediatric approval of abortive therapy with triptans have led to significant advances in the management of migraine in children. Some challenges to preventive therapy were recently noted with the negative results obtained in the Childhood and Adolescent Migraine Prevention Study, which compared prescription drugs to placebo. Inherent differences between adult and pediatric headaches, with shorter duration of pediatric migraine and prominent placebo effect, present recurring challenges for clinicians. [Pediatr Ann. 2018;47(2):e55-e60.].
偏头痛是儿科最常见的神经系统疾病之一。它可能是一个重大的压力源,导致缺课以及打乱父母的工作和家庭日程安排。治疗的主要方法仍然是对患者进行关于健康生活方式的教育,以及讲解睡眠、压力源和水合作用对引发偏头痛发作的影响。心理疗法,如生物反馈或认知行为疗法,可能对一些患者有益,尤其是那些有明显心理合并症的患者。偏头痛病理生理学的新进展以及曲坦类药物在儿科预防性治疗方面的额外批准,已使儿童偏头痛的管理取得了重大进展。最近在儿童和青少年偏头痛预防研究中得到了阴性结果,该研究将处方药与安慰剂进行了比较,这凸显了预防性治疗面临的一些挑战。成人和儿童头痛之间存在固有差异,儿童偏头痛持续时间较短且安慰剂效应显著,这给临床医生带来了反复出现的挑战。[《儿科年鉴》。2018年;47(2):e55 - e60。]