青少年偏头痛、新每日持续性头痛和持续性创伤后头痛的持续性头痛特征比较。
Comparison of continuous headache features in youth with migraine, new daily persistent headache, and persistent post-traumatic headache.
机构信息
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
出版信息
Cephalalgia. 2023 Jan;43(1):3331024221131331. doi: 10.1177/03331024221131331.
OBJECTIVE
To compare clinical features in youth with continuous headache from migraine, persistent post-traumatic headache, and new daily persistent headache to determine if they are similar, contrary to their distinction in the International Classification of Headache Disorders.
METHODS
We pursued a single center age- and sex-matched observational study comparing the clinical characteristics of 150 youth (11 - 17 years old) with continuous headache from migraine, persistent post-traumatic headache, and new daily persistent headache. A diagnostic algorithm based on international classification of headache disorders criteria was used to identify those with migraine (headache features of migraine with gradual onset), and persistent post-traumatic headache and new daily persistent headache (based on the circumstances of headache onset regardless of headache features). Fifty participants each with migraine, persistent post-traumatic headache, and new daily persistent headache were matched by age and sex. Participant survey responses on headache characteristics were compared.
RESULTS
Median usual headache severity was 6.0 [95%CI 6.0, 6.0] and was not different across diagnostic groups (H statistic = 1.2, p = 0.55). Headache exacerbation frequency, disability, associated symptoms, and most triggers were not significantly different across groups. The majority of persistent post-traumatic headache and new daily persistent headache had headache features consistent with a diagnose of migraine (72% and 62%, respectively).
CONCLUSION
Our findings suggest that most persistent post-traumatic headache and new daily persistent headache may represent abrupt onset of migraine.
目的
比较偏头痛持续状态、持续性创伤后头痛和新发作的每日持续性头痛青少年患者的临床特征，以确定它们是否与国际头痛疾病分类的区别相矛盾。
方法
我们进行了一项单中心、年龄和性别匹配的观察性研究，比较了 150 名（11-17 岁）偏头痛持续状态、持续性创伤后头痛和新发作的每日持续性头痛青少年患者的临床特征。采用基于国际头痛疾病分类标准的诊断算法来识别偏头痛（头痛特征符合偏头痛逐渐发作）、持续性创伤后头痛和新发作的每日持续性头痛（基于头痛发作的情况，而不论头痛特征如何）。每个偏头痛、持续性创伤后头痛和新发作的每日持续性头痛患者均匹配 50 名年龄和性别相同的患者。比较患者头痛特征的问卷调查回答。
结果
中位数常见头痛严重程度为 6.0[95%CI 6.0,6.0]，且在诊断组之间无差异（H 统计量=1.2，p=0.55）。头痛加重频率、残疾、伴随症状和大多数诱因在各组之间无显著差异。大多数持续性创伤后头痛和新发作的每日持续性头痛具有符合偏头痛诊断的头痛特征（分别为 72%和 62%）。
结论
我们的发现表明，大多数持续性创伤后头痛和新发作的每日持续性头痛可能代表偏头痛的突然发作。
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