Yang Hong, Liu WeiHong, Zou QiuYang, Li DeJiang
Department of Pediatrics, Affiliated Hospital of Beihua University, Jilin City, Jilin Province, China.
Department of Sports Medicine, Jilin Central Hospital, Jilin City, Jilin Province, 132000, China.
Curr Pain Headache Rep. 2025 May 27;29(1):91. doi: 10.1007/s11916-025-01403-1.
This review aims to summarize the current understanding of cluster headaches (CH) in children, focusing on epidemiology, pathophysiology, clinical characteristics, diagnostic challenges, treatment strategies, and future research directions.
Cluster headaches in children are infrequent, with an incidence that appears to be significantly lower than that observed in adults, highlighting the need for more comprehensive studies. Pediatric patients often present with atypical symptoms, such as shorter pain duration and less pronounced autonomic features, leading to frequent misdiagnosis or delayed diagnosis. The hypothalamus plays a central role in the pathophysiology of CH, involving circadian rhythm disturbances, trigeminal nerve-vascular activation, and autonomic dysfunction. High-flow oxygen and triptan medications are effective for acute treatment in adults, but their safety and efficacy in children require further validation. Preventive treatments, such as verapamil, are used cautiously in pediatric patients, with close monitoring for side effects. Non-pharmacological interventions, including lifestyle adjustments and psychological support, are critical for long-term management. Cluster headaches in children are a rare but debilitating condition that poses significant diagnostic and therapeutic challenges. Current diagnostic criteria, primarily based on adult data, may not fully capture the unique clinical features of pediatric patients, leading to misdiagnosis or missed diagnosis. Treatment strategies are largely extrapolated from adult studies, with limited evidence-based data for children. Future research should focus on improving diagnostic criteria, exploring pediatric-specific pathophysiological mechanisms, and validating safe and effective treatment options. Early identification and intervention are essential to improving the quality of life and long-term outcomes for pediatric patients.
本综述旨在总结目前对儿童丛集性头痛（CH）的认识，重点关注流行病学、病理生理学、临床特征、诊断挑战、治疗策略及未来研究方向。
儿童丛集性头痛并不常见，其发病率似乎显著低于成人，这凸显了开展更全面研究的必要性。儿科患者常表现出非典型症状，如疼痛持续时间较短且自主神经特征不明显，导致频繁误诊或诊断延迟。下丘脑在丛集性头痛的病理生理学中起核心作用，涉及昼夜节律紊乱、三叉神经血管激活及自主神经功能障碍。高流量吸氧和曲坦类药物对成人急性治疗有效，但它们在儿童中的安全性和有效性尚需进一步验证。预防性治疗，如维拉帕米，在儿科患者中使用时需谨慎，并密切监测副作用。非药物干预措施，包括生活方式调整和心理支持，对长期管理至关重要。儿童丛集性头痛是一种罕见但使人衰弱的疾病，带来了重大的诊断和治疗挑战。目前的诊断标准主要基于成人数据，可能无法完全捕捉儿科患者的独特临床特征，导致误诊或漏诊。治疗策略很大程度上是从成人研究推断而来，针对儿童的循证数据有限。未来研究应聚焦于改进诊断标准、探索儿童特有的病理生理机制以及验证安全有效的治疗方案。早期识别和干预对于提高儿科患者的生活质量和长期预后至关重要。
