Department of Pediatrics, 53176Herlev Hospital, Herlev, Denmark.
J Child Neurol. 2022 Jun;37(7):642-651. doi: 10.1177/08830738221100888. Epub 2022 May 23.
Although migraine in adult and pediatric patients are overall very similar to each other, differences in prevalence, presentation, and treatment efficacy may reflect slight differences in the pathophysiological processes underlying migraine in these patient groups, perhaps because of ongoing development of the nervous system during childhood and adolescence. Although major gains have been made in understanding the pathophysiology of migraine in adults in recent years, equivalent research on migraine in pediatric patients continues to lag behind. In this review, we will describe the current state of migraine research in pediatric patients with regard to presentation and frequency of prodromal and postdromal symptoms, ictal and interictal calcitonin gene-related peptide elevation, and evidence for cortical spreading depression, thus covering all phases of migraine, and discuss how the findings seen here may relate to possible underlying pathophysiological mechanisms of migraine. We aim to elucidate possible differences between migraine in children and adults, and the need for further research specific to pediatric patients with migraine in order to improve treatment in this patient group.
虽然成人和儿科患者的偏头痛总体上非常相似，但患病率、表现和治疗效果的差异可能反映了这两个患者群体中偏头痛潜在病理生理过程的细微差异，这可能是由于儿童和青少年时期神经系统的持续发育所致。尽管近年来在理解成人偏头痛的病理生理学方面取得了重大进展，但针对儿科患者偏头痛的等效研究仍滞后不前。在这篇综述中，我们将描述儿科患者偏头痛研究的现状，包括前驱和后驱症状的出现和频率、发作期和发作间期降钙素基因相关肽升高，以及皮质扩散性抑制的证据，从而涵盖偏头痛的所有阶段，并讨论这里的发现如何与偏头痛的潜在病理生理机制相关。我们旨在阐明儿童偏头痛与成人偏头痛之间的可能差异，以及针对偏头痛儿科患者进行进一步研究的必要性，以改善该患者群体的治疗效果。
