儿童头痛的病因、临床表现、检查结果及预防措施评估

Evaluation of the Etiology, Clinical Presentation, Findings and Prophylaxis of Children with Headache.

作者信息

Kilic Betul

机构信息

Department of Pediatric Neurology, University of Health Sciences Turkey Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

出版信息

Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):128-133. doi: 10.14744/SEMB.2019.36604. eCollection 2021.

DOI:10.14744/SEMB.2019.36604

PMID:33935547

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8085460/

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。