NeurAbilities Healthcare, NJ, Voorhees, USA.
Curr Pain Headache Rep. 2023 Oct;27(10):623-629. doi: 10.1007/s11916-023-01153-y. Epub 2023 Aug 11.
Migraine is a common condition affecting an estimated billion people across the world. The incidence in individuals with neurodevelopmental disorders or intellectual disabilities like those seen in severe autism spectrum disorder (ASD) is unknown. This is likely due to the limited capacity to communicate the specifics of pain. The expression of pain with maladaptive behaviors, such as self-injurious behavior (SIB), has been described and can alert the clinician to the presence of untreated pain. This review article serves to educate the reader about clinical and treatment considerations when managing headaches in individuals with severe or non-verbal neurodevelopmental disorders given their communication challenges. It will include some clinical experiences and the gaps in our current knowledge.
A comprehensive literature review was conducted using scientific databases, including PubMed, Medline, and Google Scholar. Only 1 article addressed the consideration for headaches in this population. The search was conducted using a combination of the following keywords: headache, intellectual disabilities, autism, pain, and behavior. Headache pain is likely underestimated and represents a disservice to this population of people. The consideration for headache pain should be explored when maladaptive behaviors are otherwise unexplainable. Further studies are needed in the area.
偏头痛是一种常见疾病，据估计影响着全球约 10 亿人。在患有神经发育障碍或智力残疾的个体中的发病率尚不清楚，比如在严重自闭症谱系障碍（ASD）中。这可能是由于有限的能力来准确表达疼痛的细节。疼痛的表达方式可能会出现适应不良的行为，如自伤行为（SIB），这已经被描述过，并可以提醒临床医生存在未经治疗的疼痛。本文旨在向读者介绍在管理严重或非语言神经发育障碍个体的头痛时的临床和治疗注意事项，因为这些患者在沟通方面存在挑战。它将包括一些临床经验和我们当前知识中的空白。
使用科学数据库，包括 PubMed、Medline 和 Google Scholar，进行了全面的文献综述。只有 1 篇文章探讨了在这一人群中头痛的注意事项。搜索使用了以下关键词的组合：头痛、智力残疾、自闭症、疼痛和行为。头痛疼痛很可能被低估了，这对这部分人群是不利的。当适应不良的行为无法解释时，应考虑头痛疼痛的问题。这一领域还需要进一步的研究。
