Department of Emergency & Disaster, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Neurology, Saiseikai Siga Hospital, Ritto, Japan.
Headache. 2019 Jul;59(7):1084-1087. doi: 10.1111/head.13580. Epub 2019 Jul 1.
Paroxysmal hemicrania (PH) is a rare primary headache disorder, especially among children. We describe herein a case with the shortest course of pediatric PH among previously reported cases, and the first case report of Japanese pediatric PH. An 11-year-old boy was referred to our clinic by his primary care physician for a headache evaluation. He had been complaining of severe, sharp, pulsating headache for 5 days. Attacks were restricted to the left side with a duration ranging from 2 to 20 minutes, 20-30 times a day. Attacks were associated with left autonomic symptoms (conjunctival injection, lacrimation, nasal congestion, eyelid edema, and ptosis). Two days after we prescribed indomethacin at 0.9 mg/kg/day, the patient was headache free. He stopped taking indomethacin 14 days after consultation because of drug eruptions. As of the time of writing, more than 1 year later, he has experienced no recurrence of headache. This case indicates the importance of improving awareness among general doctors regarding PH in children, and of conducting further investigations about low-dose, short-term indomethacin treatment.
阵发性偏头痛 (PH) 是一种罕见的原发性头痛疾病，尤其在儿童中较为少见。我们在此描述了一例此前报道的儿童 PH 中病程最短的病例，也是首例日本儿童 PH 的病例报告。一名 11 岁男孩因头痛就诊于我院，此前他的初级保健医生已对其进行了头痛评估。他持续 5 天出现严重、锐痛、搏动性头痛。发作仅限于左侧，每次持续 2 至 20 分钟，每天发作 20-30 次。发作伴有左侧自主神经症状（结膜充血、流泪、鼻塞、眼睑水肿和下垂）。我们给患者开了吲哚美辛，剂量为 0.9 毫克/千克/天，两天后，患者头痛缓解。因出现药物疹，患者在就诊 14 天后停止服用吲哚美辛。截至撰写本文时，1 年多后，患者未再出现头痛复发。该病例表明，提高普通医生对儿童 PH 的认识，并进一步探讨低剂量、短期吲哚美辛治疗的重要性。
