儿童和青少年偏瘫性偏头痛
Hemiplegic Migraine in Children and Adolescents.
作者信息
Bonemazzi Ilaria, Brunello Francesco, Pin Jacopo Norberto, Pecoraro Mattia, Sartori Stefano, Nosadini Margherita, Toldo Irene
机构信息
Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy.
出版信息
J Clin Med. 2023 May 31;12(11):3783. doi: 10.3390/jcm12113783.
BACKGROUND
Only a few studies have focused on hemiplegic migraine (HM) in children despite its early age of onset. The aim of this review is to describe the peculiar characteristics of pediatric HM.
METHODS
This is a narrative review based on 14 studies on pediatric HM selected from 262 papers.
RESULTS
Different from HM in adults, pediatric HM affects both genders equally. Early transient neurological symptoms (prolonged aphasia during a febrile episode, isolated seizures, transient hemiparesis, and prolonged clumsiness after minor head trauma) can precede HM long before its onset. The prevalence of non-motor auras among children is lower than it is in adults. Pediatric sporadic HM patients have longer and more severe attacks compared to familial cases, especially during the initial years after disease onset, while familial HM cases tend to have the disease for longer. During follow-up, the frequency, intensity, and duration of HM attacks often decrease. The outcome is favorable in most patients; however, neurological conditions and comorbidities can be associated.
CONCLUSION
Further studies are needed to better define the clinical phenotype and the natural history of pediatric HM and to refine genotype-phenotype correlations in order to improve the knowledge on HM physiopathology, diagnosis, and outcome.
背景
尽管偏瘫性偏头痛（HM）发病年龄较早，但仅有少数研究关注儿童偏瘫性偏头痛。本综述的目的是描述儿童HM的特殊特征。
方法
这是一项叙述性综述，基于从262篇论文中筛选出的14项关于儿童HM的研究。
结果
与成人HM不同，儿童HM对两性的影响相同。早期短暂性神经症状（发热发作时的持续性失语、孤立性癫痫发作、短暂性偏瘫以及轻度头部外伤后持续性笨拙）可在HM发作前很长时间出现。儿童非运动性先兆的患病率低于成人。与家族性病例相比，儿童散发性HM患者的发作时间更长、更严重，尤其是在疾病发作后的最初几年，而家族性HM病例的患病时间往往更长。在随访期间，HM发作的频率、强度和持续时间通常会降低。大多数患者的预后良好；然而，可能会伴有神经疾病和合并症。
结论
需要进一步研究以更好地界定儿童HM的临床表型和自然病史，并完善基因型与表型的相关性，从而增进对HM生理病理学、诊断和预后的认识。
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