Paediatric Neurosciences Unit, Royal Hospital for Children, Glasgow, UK.
Neurology and Pediatrics, University of California San Francisco, San Francisco, CA, USA.
Nat Rev Neurol. 2021 Jul;17(7):449-458. doi: 10.1038/s41582-021-00497-6. Epub 2021 May 26.
Migraine is a complex genetic brain disorder with an intricate pathogenesis and polymorphous clinical presentations, particularly in children. In this Perspective, we describe the different phenotypes of migraine in children, including conditions that have been referred to in the International Classification of Headache Disorders as "syndromes that may be related to migraine''. Evidence is presented for the integration of abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis and infantile colic into the unified diagnosis of 'childhood migraine syndrome' on the basis of clinical and epidemiological characteristics, and shared inheritance. In our opinion, such integration will guide clinicians from specialities other than neurology to consider migraine in the assessment of children with these disorders, as well as stimulate research into the genetics, pathophysiology and clinical features of all disorders within the syndrome. A diagnosis of childhood migraine syndrome would also enable patients to benefit from inclusion in clinical trials of old and new migraine treatments, thus potentially increasing the number of treatment options available.
偏头痛是一种复杂的遗传性脑部疾病，其发病机制复杂，临床表现多样，尤其在儿童中更是如此。在本文观点中，我们描述了儿童偏头痛的不同表型，包括国际头痛疾病分类中被称为“可能与偏头痛相关的综合征”的病症。有证据表明，基于临床和流行病学特征以及共同遗传，将腹型偏头痛、周期性呕吐综合征、良性阵发性眩晕、良性阵发性斜颈和婴儿绞痛纳入“儿童偏头痛综合征”的统一诊断中。我们认为，这种整合将指导神经科以外的其他专业临床医生在评估这些疾病的儿童时考虑偏头痛，并促使对综合征内所有疾病的遗传学、病理生理学和临床特征进行研究。儿童偏头痛综合征的诊断也将使患者能够从旧的和新的偏头痛治疗的临床试验中受益，从而可能增加可用的治疗选择数量。
