Section of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio.
Section of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio; Department of Neurology, The Ohio State University College of Medicine, Columbus, Ohio.
Pediatr Neurol. 2019 Aug;97:26-29. doi: 10.1016/j.pediatrneurol.2019.03.023. Epub 2019 Mar 29.
We evaluated the frequency of six commonly reported adult migraine premonitory symptoms in children and adolescents with episodic and chronic migraine and elicited psychological or behavioral comorbidities that may be associated with these symptoms.
Premonitory symptoms are commonly reported in the adult migraine population; however, little information is available for the pediatric population.
Data were collected on new patients being evaluated in our multidisciplinary pediatric headache clinic over a six-month time interval. The data collected from patients diagnosed with migraine were then reviewed for the following premonitory symptoms: yawning, neck stiffness, fatigue, increased urination, mood changes, and food cravings. History was obtained regarding the frequency of headaches and other associated behavioral or psychological problems.
A total of 176 patients were enrolled over a six-month interval, ranging in age from four to 18 years (mean age 12 years); 64% were female, and 42% (74 of 176) of the subjects had at least one premonitory symptom. Patients with migraine with aura were noted to have a significantly higher association with premonitory symptoms (59%, 30 of 51) (P < 0.05). Anxiety disorder was also significantly associated with premonitory symptoms (55%, 11 of 20) (P < 0.05). Fatigue and mood changes were the most commonly reported premonitory symptoms.
Premonitory symptoms occurred frequently in our population of pediatric patients with migraine. Fatigue and mood changes were the most frequent symptoms. There were no significant differences in premonitory symptoms by gender or age group (less than 12 years versus greater than 12 years). Anxiety and migraine with aura were correlated with an increased likelihood of premonitory symptoms.
我们评估了发作性和慢性偏头痛儿童和青少年中六种常见报告的成人偏头痛前驱症状的频率，并引出可能与这些症状相关的心理或行为共病。
前驱症状在成人偏头痛人群中常被报告；然而，儿科人群的信息有限。
在六个月的时间间隔内，我们从参加我们的多学科儿科头痛诊所评估的新患者中收集数据。然后，对诊断为偏头痛的患者的数据进行了回顾，以评估以下前驱症状：打哈欠、颈部僵硬、疲劳、多尿、情绪变化和食物渴望。还获得了有关头痛发作频率和其他相关行为或心理问题的病史。
在六个月的时间间隔内共招募了 176 名患者，年龄从 4 岁到 18 岁（平均年龄 12 岁）；64%为女性，42%（176 名患者中的 74 名）至少有一种前驱症状。有先兆偏头痛患者明显与前驱症状相关（59%，30/51）（P<0.05）。焦虑障碍也与前驱症状显著相关（55%，11/20）（P<0.05）。疲劳和情绪变化是最常报告的前驱症状。
前驱症状在我们的偏头痛儿科患者人群中频繁发生。疲劳和情绪变化是最常见的症状。前驱症状在性别或年龄组（小于 12 岁与大于 12 岁）之间无显著差异。焦虑和有先兆偏头痛与前驱症状的可能性增加相关。
