Winner P, Martinez W, Mate L, Bello L
Palm Beach Headache Center, FL 33407, USA.
Headache. 1995 Jul-Aug;35(7):407-10. doi: 10.1111/j.1526-4610.1995.hed3507407.x.
The International Headache Society classification lends itself to modification to significantly improve the diagnostic sensitivity of migraine in the pediatric population. Children and adolescents require special modifications relating to duration, location, quality of intensity, and symptoms related to photophobia and phonophobia. We propose specific criteria for pediatric migraine with and without aura which are more sensitive. Forty-five children and adolescents seen at a headache center were evaluated, retrospectively, comparing diagnostic criteria of the International Headache Society, Vahlquist, and the proposed revised IHS classification for clinical diagnosis by a single examiner (pediatric neurologist)--comparing diagnostic rates for migraine of the total sample: IHS (53%), Vahlquist (69%), and IHS-R (80%) and evaluating a subset of those patients less than 12 years (n = 22): IHS (50%), Vahlquist (68%), and IHS-R (73%). The proposed revisions to IHS for pediatric migraine were more sensitive than existing criteria. These revisions may help to form the basis for future research guidelines and for further modifications to improve the diagnostic sensitivity of pediatric migraine using the IHS model.
国际头痛协会的分类易于修改，可显著提高偏头痛在儿科人群中的诊断敏感性。儿童和青少年在持续时间、部位、强度性质以及与畏光和畏声相关的症状方面需要特殊修改。我们提出了更敏感的有先兆和无先兆儿童偏头痛的具体标准。对一家头痛中心的45名儿童和青少年进行了回顾性评估，比较了国际头痛协会、瓦尔奎斯特的诊断标准以及由一名检查者（儿科神经科医生）进行临床诊断时提议的修订后的国际头痛协会分类——比较总样本中偏头痛的诊断率：国际头痛协会（53%）、瓦尔奎斯特（69%）和国际头痛协会修订版（80%），并评估了其中年龄小于12岁的患者子集（n = 22）：国际头痛协会（50%）、瓦尔奎斯特（68%）和国际头痛协会修订版（73%）。提议的国际头痛协会儿童偏头痛修订版比现有标准更敏感。这些修订可能有助于为未来的研究指南以及使用国际头痛协会模型进一步改进儿童偏头痛诊断敏感性的进一步修改奠定基础。
