Vasconcellos E, Piña-Garza J E, Millan E J, Warner J S
Department of Neurology and the Pediatric Headache Clinic, Vanderbilt University Medical Center, Nashville, TN 37212, USA.
J Child Neurol. 1998 Sep;13(9):443-7. doi: 10.1177/088307389801300906.
For more than a decade, the frequent use of analgesics has been recognized to lead to daily headaches in adults. To date, no studies on the occurrence of analgesic rebound headache have been done on the pediatric population. We retrospectively reviewed all charts of patients with the diagnosis of headache seen in our pediatric headache clinic between January 1996 and May 1997. Among the 98 patients seen, 46 (47%) suffered from daily or near daily headaches; 30 of them were consuming daily analgesics. Twenty-four patients (mean age 12.1 years, and mean follow-up 6.2 months) successfully discontinued their analgesics. Twenty-two patients were also placed on amitriptyline. A significant reduction in the frequency (80%), severity (47%), and number of school days missed (74%) were seen. In conclusion, this data is comparable to previous observations reported in adults, and suggests that the daily use of analgesics might result in daily or near daily headaches in the pediatric population. Discontinuing daily analgesics, with the concomitant use of amitriptyline, is an effective treatment for analgesic rebound headache in this population.
十多年来，人们已经认识到成年人频繁使用镇痛药会导致每日头痛。迄今为止，尚未对儿科人群进行过关于镇痛药反跳性头痛发生率的研究。我们回顾性地查阅了1996年1月至1997年5月期间在我们儿科头痛诊所就诊的所有诊断为头痛的患者病历。在98例就诊患者中，46例（47%）患有每日或几乎每日头痛；其中30例每日服用镇痛药。24例患者（平均年龄12.1岁，平均随访6.2个月）成功停用了镇痛药。22例患者还服用了阿米替林。结果发现头痛频率（80%）、严重程度（47%）和缺课天数（74%）均显著降低。总之，这些数据与先前在成年人中报告的观察结果相当，表明每日使用镇痛药可能导致儿科人群每日或几乎每日头痛。停用每日镇痛药并同时使用阿米替林是该人群中治疗镇痛药反跳性头痛的有效方法。
