Reconsideration of the diagnosis and treatment of childhood migraine: A practical review of clinical experiences

被引：6

作者：

Saito, Yoshiaki ^{[1
]}

Yamanaka, Gaku ^{[2
]}

Shimomura, Hideki ^{[3
]}

Shiraishi, Kazuhiro ^{[4
]}

Nakazawa, Tomoyuki ^{[5
]}

Kato, Fumihide ^{[6
]}

Shimizu-Motohashi, Yuko ^{[7
]}

Sasaki, Masayuki ^{[7
]}

Maegaki, Yoshihiro ^{[1
]}

机构：

[1] Tottori Univ, Div Child Neurol, Dept Brain & Neurosci, Fac Med, 36-1 Nishi Cho, Yonago, Tottori 6838504, Japan

[2] Tokyo Med Univ, Dept Pediat, Shinjuku Ku, Tokyo, Japan

[3] Shiga Med Ctr Children, Dept Pediat, Moriyama, Japan

[4] Natl Hosp Org, Utano Natl Hosp, Dept Pediat Neurol, Kyoto, Japan

[5] Tokyo Metropolitan Hlth & Med Treatment Corp, Toshima Hosp, Dept Pediat, Tokyo, Japan

[6] Shimane Prefectural Cent Hosp, Div Pediat, Izumo, Shimane, Japan

[7] Natl Ctr Neurol & Psychiat, Dept Child Neurol, Kodaira, Tokyo, Japan

来源：

BRAIN & DEVELOPMENT | 2017年 / 39卷 / 05期

关键词：

Migraine; Childhood; Orthostatic dysregulation; Autism spectrum disorders; Pervasive developmental disorder; CHRONIC DAILY HEADACHE; PEDIATRIC MIGRAINE; SODIUM VALPROATE; RANDOMIZED-TRIAL; PROPHYLAXIS; PROPRANOLOL; ADOLESCENTS; MANAGEMENT; CHILDREN; ATTACKS;

D O I：

10.1016/j.braindev.2016.11.011

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To provide insight into the wide spectrum of migraine during childhood to establish practical and comprehensive treatment strategies. Background: Although recent studies have confirmed the effect of anti-migraine agents in childhood headaches fulfilling the criteria of migraine without aura, there have been no studies regarding the efficacy of these drugs in childhood migraine without aura not filling the diagnostic criteria. Methods: In total, 154 patients with a clinical diagnosis of migraine, with onset of repetitive headaches at the age of <= 15 years, were retrospectively included from clinics in seven tertiary medical centers. Results: Patients' diagnoses included migraine with aura (n = 49), migraine without aura (n = 65), clinical migraine without aura not fulfilling International Classification of Headache Disorders-3 beta criteria (suspected migraine without aura; n = 38), and hemiplegic migraine (n = 2). Abortive medicine was effective in 74 of 97 patients, and preventive medicine was effective in 61 of 84 patients. Drugs with high efficacy were acetaminophen and ibuprofen for abortive therapy and cyproheptadine, amitriptyline, and propranolol for preventive therapy. Psychosocial problems were less common, and abnormalities on electroencephalography were more common in the suspected migraine without aura group. Otherwise, clinical features and drug responsibility were comparable among the migraine with aura, migraine without aura, and suspected migraine without aura groups. Retrospectively, experts clinically diagnosed childhood migraine without aura when the headache met at least one of the three criteria B, C, and D in International Classification of Headache Disorders-3 beta in addition to A and E. Abortive and preventive medication including paroxetine (n = 2) benefited 10 and 15 of the 33 patients with daily headache, respectively. Psychotherapy/counseling (n = 4), treatment for orthostatic dysregulation (n = 4), and elimination of stressors (n = 3) markedly alleviated headache in this group. Conclusion: Our results indicated that those with suspected migraine without aura not filling International Classification of Headache Disorders diagnostic criteria should be included in the treatment for migraine. Treatment should also be targeted to comorbid developmental disorders, orthostatic dysregulation, and psychosocial problems in patients with refractory daily headaches. (C) 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved

引用

页码：386 / 394

页数：9

共 28 条

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