儿童和青春期偏头痛临床特点

CLINICAL CHARACTERISTICS OF MIGRAINE IN CHILDHOOD AND ADOLESCENCE

目的:通过与成年偏头痛患者临床特点比较,探讨儿童和青春期偏头痛的临床特点。方法:解放军总医院神经内科门诊2005年1月～2006年12月收集的45例儿童和青春期偏头痛及224例成年偏头痛患者,分析其一般资料及临床特点,包括头痛的发作频率、持续时间、程度、部位、性质和伴随症状。结果:(1)儿童和青春期以及成年偏头痛患者男女比例分别为1:1.05和1:3.48(χ2=13.493,P<0.001);有先兆偏头痛占儿童和青春期以及成年偏头痛患者的比例分别为53.3%和21.9%(χ2=18.754,P<0.001)。(2)儿童和青春期以及成年偏头痛患者的头痛发作频率分别为1(1～2)次/月和2(1～3)次/月(P=0.032),持续时间分别为6(2.5～24)h和24(7.25～36)h(P=0.001),头痛程度VAS分别为7.5(6～8)和8(7～9)(P=0.002)。(3)儿童和青春期以及成年偏头痛患者单侧头痛所占各自比例分别为57.8%和65.2%(P=0.345),搏动性头痛占头痛性质比例分别为55.6%和67.9%(P=0.112)。(4)儿童和青春期以及成年偏头痛患者出现伴随症状的比例分别为:恶心呕吐88.9%和92.0%(P=0.501),畏光怕声60.0%和70.5%(P=0.164),不愿活动86.7%和74.1%(P=0.071)。结论:与成年偏头痛相比,儿童及青春期偏头痛患者的临床特点包括:男女比例接近,易出现先兆症状,持续时间更短、疼痛程度较轻、发作频率更少;二者的头痛部位、头痛性质以及伴随症状相近。

Objective： To analyze clinical characteristics of migraine in childhood and adolescence. Method：Clinical manifestations of 269 patients which include 45 children and 224 adults were analyzed retrospectively. Patients were collected in department of neurology in PLA General Hospital from 2005 to 2006 and information collected included demographic data, attack frequency, duration, severity, location, quality and associated symptoms of headache. Results：The male/female ratio is 1：1.05 for adults and 1：3.48 for children （X^2= 13.493, P 〈0.001） ; The ratio of migraine with aura is 53.3% for children and 21.9% for adults（X^2=18.754, P 〈0.001） ;The attack frequency, duration, severity of head-ache are 1（1-2））/month vs. 2 （1-3） /month （P=0.032）, 6 （2.5-24）h vs. 24（7.25-36）h （P=0.001） and 7.5（6-8） vs. 8（7-9） （P= 0.002） respectively ; there was no significant difference in proportion of unilateral headache （children 57.8% vs. adults 65.2%, P = 0.345） and pulsatile headache （children 55.6% vs. adults 67.9%, P = 0. 112）. No significant difference was observed in associated symptoms （nausea and vomiting： 88.9% vs. 92.0% , P = 0. 501 ; photophobia and phonophobia： 60.0% vs. 70.5% , P =0. 164; aggravation after activity： 86.7% vs. 74.1% , P =0.071 ）. Conclusion：Migraine with aura may be more common in children and adolescent than that in mature; Migraine in childhood and adolescence seemed to be characterized as shorter duration, milder severity and minor attack frequency. Two kinds of above-mentioned migraineurs may share similar location, quality and associated symptoms of headache.