Forcelini Cassiano Mateus, Ramos Matheus, Santos Isadora Ferraz Dos, Brackmann Gabriela, Bernardon Lucas Grumann, Corbellini Ana Paula Zanella, Perin Bruna Valentina
Universidade de Passo Fundo, Faculdade de Medicina, Passo Fundo, RS, Brasil.
Arq Neuropsiquiatr. 2019 Jul 15;77(6):418-423. doi: 10.1590/0004-282X20190058.
Migraine is a common condition in the pediatric population and causes a significant impact on the quality of life. Atopic disorders are some of the migraine comorbidities. We hypothesized that allergic rhinitis could aggravate migraine in the pediatric population.
This cross-sectional study consecutively evaluated 90 pediatric outpatients (46 children 6-12 years of age; 44 adolescents up to 18 years of age) who sought medical assistance because of migraine at a general neurology clinic in Passo Fundo, RS, Brazil. They, and their parents, were given three questionnaires, to evaluate the diagnosis of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis, as well as the disability caused by headache (ISAAC - International Study of Asthma and Allergies in Childhood; CARATkids - Control of Allergic Rhinitis and Asthma Test for Children; PedMIDAS - Pediatric Migraine Disability Assessment). The study was approved by the local ethics committee.
According to the ISAAC questionnaire, children with current allergic rhinoconjunctivitis in the last year showed higher scores on the PedMIDAS than those patients without atopy (median and interquartile range 26 [10-58] vs. 5 [1-13], p = 0.008). A significant positive correlation of CARATkids scores with PedMIDAS scores was found (p = 0.007, rho = 0.39). After including other putative predictors of migraine disability (age, body mass index, time since onset of migraine) in a multiple regression analysis, only the scores on the CARATkids remained a significant independent variable correlated with PedMIDAS scores (p = 0.001; R = 0.55; R2 = 0.30).
Current allergic rhinoconjunctivitis is related to enhanced disability caused by headache in childhood migraine.
偏头痛在儿科人群中很常见，对生活质量有重大影响。特应性疾病是偏头痛的一些合并症。我们假设变应性鼻炎会加重儿科人群的偏头痛。
这项横断面研究连续评估了90名儿科门诊患者（46名6 - 12岁儿童；44名18岁以下青少年），他们因偏头痛在巴西南里奥格兰德州帕索丰杜的一家普通神经科诊所寻求医疗帮助。他们及其父母被给予三份问卷，以评估当前变应性鼻炎、变应性鼻结膜炎和季节性变应性鼻炎的诊断，以及头痛导致（儿童哮喘和变应性疾病国际研究；儿童变应性鼻炎和哮喘控制测试；儿童偏头痛残疾评估）的残疾情况。该研究得到了当地伦理委员会的批准。
根据儿童哮喘和变应性疾病国际研究问卷，去年患有当前变应性鼻结膜炎的儿童在儿童偏头痛残疾评估中的得分高于无特应性的患者（中位数和四分位间距为26 [10 - 58] 对比5 [1 - 13]，p = 0.008）。发现儿童变应性鼻炎和哮喘控制测试得分与儿童偏头痛残疾评估得分呈显著正相关（p = 0.007，rho = 0.39）。在多元回归分析中纳入偏头痛残疾的其他假定预测因素（年龄、体重指数、偏头痛发作时间）后，只有儿童变应性鼻炎和哮喘控制测试得分仍然是与儿童偏头痛残疾评估得分相关的显著独立变量（p = 0.001；R = 0.55；R2 = 0.30）。
当前变应性鼻结膜炎与儿童偏头痛中头痛导致的残疾加重有关。
