Papetti Laura, Sforza Giorgia, Tarantino Samuela, Moavero Romina, Ruscitto Claudia, Ursitti Fabiana, Ferilli Michela Ada Noris, Vigevano Federico, Valeriani Massimiliano
Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy.
Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy.
Diagnostics (Basel). 2021 Feb 24;11(3):385. doi: 10.3390/diagnostics11030385.
Our aim was to investigate the clinical features of primary new daily persistent headache (NDPH) in a cohort of paediatric patients.
We reviewed the data of patients with persistent daily headache, attending the Headache Centre of Bambino Gesù Children from the January 2009. The ICHD-III criteria were used for diagnosis. Statistical analysis was conducted to study possible correlations between NDPH and population features (age and sex), NDPH and headache qualitative features, and NDPH and response to pharmacological therapies.
We included 46 subjects with NDPH. The features of pain more closely resembled those of migraine than to those of tension-type headache (62 vs. 38%). The NDPH patients showed nausea and vomiting less frequently than migraine ones (28.6 vs. 48.2%, < 0.01). A total of 75% of NDPH patients experienced an onset of the symptoms in the winter months (November to February) ( < 0.01). NDPH was less common in very young children under 10 years of age. Almost 58% of NDPH patients received pharmacological therapy and the most used drug was amitriptyline. A reduction of attacks by at least 50% in a month was detected in 30.6% of patients.
NDPH can be very disabling and correlates with seasonal factors. Although long term pharmacological therapy is recommended, considering the long duration that this headache can have, there are no data supporting the treatment choice.
我们的目的是调查一组儿科患者原发性新发性每日持续性头痛（NDPH）的临床特征。
我们回顾了自2009年1月起在 Bambino Gesù儿童医院头痛中心就诊的每日持续性头痛患者的数据。采用国际头痛疾病分类第三版（ICHD-III）标准进行诊断。进行统计分析以研究NDPH与人口统计学特征（年龄和性别）、NDPH与头痛定性特征以及NDPH与药物治疗反应之间的可能相关性。
我们纳入了46例NDPH患者。疼痛特征更类似于偏头痛而非紧张型头痛（分别为62%和38%）。NDPH患者恶心和呕吐的发生率低于偏头痛患者（分别为28.6%和48.2%，P<0.01）。共有75%的NDPH患者在冬季月份（11月至2月）出现症状发作（P<0.01）。NDPH在10岁以下的幼儿中不太常见。近58%的NDPH患者接受了药物治疗，最常用的药物是阿米替林。30.6%的患者在一个月内发作减少至少50%。
NDPH可能极具致残性且与季节因素相关。尽管考虑到这种头痛可能持续较长时间，建议进行长期药物治疗，但尚无数据支持治疗选择。
