小儿前庭性偏头痛：根据 ICHD-3 标准诊断和短期 CH 预防的有效性。
Pediatric vestibular migraine: Diagnosis according to ICHD-3 criteria and the effectiveness of short-term CH prophylaxis.
机构信息
Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Turkey.
Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Pediatrics, Turkey.
出版信息
Eur J Paediatr Neurol. 2022 Jul;39:19-24. doi: 10.1016/j.ejpn.2022.05.002. Epub 2022 May 13.
OBJECTIVE
Vestibular migraine (VM) is a rare migraine variant with limited information about its treatment in children. This study, it was aimed to evaluate the diagnostic characteristics of VM in children and the effectiveness of cyproheptadine hydrochloride (CH) prophylaxis.
METHODS
Patients aged 6-18 years who were diagnosed with VM and other primary headaches (OPHs) according to ICHD-3 diagnostic criteria and given oral CH prophylaxis for at least 3 months were included in the study. Response to CH prophylaxis was defined by the change in symptoms (worsening, no change, and improvement) monthly.
RESULTS
A total of 64 cases diagnosed with primary headache and given CH prophylaxis were identified. 40.6% (29) migraine without aura of patients, 34.4% (22) VM, 14.1% (9) tension type headache, 4.7% (3) benign paroxysmal vertigo, 3.1% (2) migraine with aura and 3.1% (2) were diagnosed with abdominal migraine. Compared to OPHs, it was found that the duration of headache attack was shorter (p .013) and vomiting, which is one of the associated symptoms, was observed less in pediatric VM (p .032). The positive response of the whole study population to CH prophylaxis was 85.9%. However, CH prophylaxis responses were higher in VM compared to OPHs at the end of 1 month (63.6%) and 2 months (86.3%).
CONCLUSION
In the pediatric population, the migrainous characters of VM may show differences, but its response to short-term CH prophylaxis is quite good.
目的
前庭性偏头痛（VM）是一种罕见的偏头痛变体，关于其在儿童中的治疗方法的信息有限。本研究旨在评估儿童 VM 的诊断特征和盐酸赛庚啶（CH）预防的有效性。
方法
根据 ICHD-3 诊断标准诊断为 VM 和其他原发性头痛（OPH）并接受口服 CH 预防治疗至少 3 个月的 6-18 岁患者纳入本研究。每月根据症状（恶化、无变化和改善）的变化来定义 CH 预防的反应。
结果
共确定了 64 例原发性头痛并接受 CH 预防的病例。40.6%（29 例）为无先兆偏头痛患者，34.4%（22 例）为 VM，14.1%（9 例）为紧张型头痛，4.7%（3 例）为良性阵发性眩晕，3.1%（2 例）为偏头痛伴先兆，3.1%（2 例）为腹型偏头痛。与 OPH 相比，VM 的头痛发作持续时间更短（p.013），且较少出现呕吐等伴随症状（p.032）。整个研究人群对 CH 预防的阳性反应率为 85.9%。然而，VM 对 CH 预防的反应在第 1 个月（63.6%）和第 2 个月（86.3%）时均高于 OPH。
结论
在儿科人群中，VM 的偏头痛特征可能存在差异，但短期 CH 预防的反应相当好。
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