Kilic Betul
Department of Pediatric Neurology, University of Health Sciences Turkey Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):128-133. doi: 10.14744/SEMB.2019.36604. eCollection 2021.
A headache is prevalent in childhood and constitutes a significant part of outpatient applications. This study aimed to evaluate the results of etiology, clinical features, examination results, prophylactic treatment and follow-up in patients with a headache.
Between January 2017 and December 2018, the files of the patients with the complaint of headache were reviewed retrospectively in this study. A headache was classified according to the International Headache Society (IHS) criteria.
In this study, 350 patients aged between 3-17 years old and the mean age of 11.2±2.7 with a headache were included; 212 (60.6%) of them was female and 138 (39.4%) of them was male. The rate of a primary headache was higher in females than in males (p=0.004). The headache causes were a migraine in 51.1%, tension-type headache in 32.3%, secondary in 13.4%, and not classified in 3.1%. The mean age of the patients with a primary headache was significantly higher than patients with a secondary headache (p<0.001). The most common trigger factor was insomnia (52.7%). Abnormal physical/neurological signs and symptoms were detected in 17 (9.49%) patients. Cranial magnetic resonance imaging (MRI) examination was performed in 121 (34.5%) patients. Abnormal findings were found in 35 (28.9%) of these. In this study, 33 patients underwent electroencephalography (EEG); none of the had an epileptiform abnormality. Flunarizine (23.2%) and cyproheptadine (7.5%) were the most administered prophylactic treatments. It was observed that all patients who had prophylaxis and who had come to control had a significant decrease in headaches.
The cause of childhood headaches is mostly migraine and tension-type headache. As long as there is no abnormality in the history and neurological examination, neuroimaging studies are not required in the routine evaluation of patients with a headache. Prophylactic treatment increases the quality of life in selected cases.
头痛在儿童期很常见，是门诊就诊的重要组成部分。本研究旨在评估头痛患者的病因、临床特征、检查结果、预防性治疗及随访结果。
本研究回顾性分析了2017年1月至2018年12月期间有头痛主诉患者的病历。根据国际头痛协会（IHS）标准对头痛进行分类。
本研究纳入了350例年龄在3至17岁之间、平均年龄为11.2±2.7岁的头痛患者；其中212例（60.6%）为女性，138例（39.4%）为男性。女性原发性头痛的发生率高于男性（p=0.004）。头痛原因中偏头痛占51.1%，紧张型头痛占32.3%，继发性头痛占13.4%，未分类头痛占3.1%。原发性头痛患者的平均年龄显著高于继发性头痛患者（p<0.001）。最常见的诱发因素是失眠（52.7%）。17例（9.49%）患者检测到异常的身体/神经体征和症状。121例（34.5%）患者进行了头颅磁共振成像（MRI）检查。其中35例（28.9%）发现异常结果。本研究中，33例患者进行了脑电图（EEG）检查；均未发现癫痫样异常。氟桂利嗪（23.2%）和赛庚啶（7.5%）是最常用的预防性治疗药物。观察到所有接受预防性治疗并前来复诊的患者头痛均有显著减轻。
儿童头痛的原因主要是偏头痛和紧张型头痛。只要病史和神经检查无异常，头痛患者的常规评估中无需进行神经影像学检查。预防性治疗在部分病例中可提高生活质量。
