Whether the prevalence of migraine is increasing is controversial. We conducte d annual surveys in 1999-2001 to investigate migraine prevalence among a nation -wide sample of 13 426 adolescents aged 13-15 years. Parti...Whether the prevalence of migraine is increasing is controversial. We conducte d annual surveys in 1999-2001 to investigate migraine prevalence among a nation -wide sample of 13 426 adolescents aged 13-15 years. Participants from five ju nior high schools around different regions of Taiwan completed selfadministered questionnaires. The diagnosis of migraine was based on the classification criter ia proposed by the International Headache Society, 1988. Data for 23 433 person -years were collected and analysed for trends in prevalence and incidence. The 1-year prevalence of migraine increased 42%during 1999-2001 (from 5.2 to 7.4 %, P < 0.001). This increasing trend was demonstrated in both sexes, all ages, and all but one studied regions of Taiwan. Of note was the biggest increment of prevalence (79%) among 7th graders (students aged 13 years) through these 3 yea rs. Annual incidence rates did not differ between 1999 and 2000 and 2000 and 200 1 (6.1%vs. 5.7%; P=0.4). One-year persistence rates of migraine diagnosis, su rrogates of migraine duration, did not differ between 1999 and 2000 and 2000 and 2001 (34.2%vs. 41.2%; P=0.1). Our study found that the prevalence of migraine was increasing in our sampled adolescents, which results from an increment star ting at age 13 or younger. The prevalence of migraine in Asians might be increas ing, although previous studies showed lower prevalence in this region. Children or adolescents may be more vulnerable to the environmental or societal change.展开更多
Aims: To determine the prevalence of serious neurological disorders among chil dren with chronic headache. Methods: All children presenting to a specialist hea dache clinic over seven years with headache as their main...Aims: To determine the prevalence of serious neurological disorders among chil dren with chronic headache. Methods: All children presenting to a specialist hea dache clinic over seven years with headache as their main complaint were assesse d by clinical history, physical and neurological examination, neuroimaging where indicated, and by follow up using prospective headache diaries. Results: A tota l of 815 children and adolescents (1.25-18.75 years of age, mean 10.8 years (SD 2.9); 432 male) were assessed. Mean duration of headache was 21.2 months (SD 21 .2). Neuroimaging (brain CT or MRI) was carried out on 142 (17.5%) children. Th e vast majority of patients had idiopathic headache (migraine, tension, or uncla ssified headaches). Fifty one children (6.3%) had other chronic neurological di sorders that were unrelated to the headache. The headache in three children (0.3 7%, 95%CI 0.08%to 1.1%)was related to active intracranial pathology which wa s predictable on clinical findings in two children but was unexpected until a la ter stage in one child (0.12%, 95%CI 0.006%to 0.68%). Conclusions: Chronic h eadache in childhood is rarely due to serious intracranial pathology. Careful hi story and thorough clinical examination will identify most patients with serious underlying brain abnormalities. Change in headache symptomatology or personalit y change should lower the threshold for imaging.展开更多
文摘Whether the prevalence of migraine is increasing is controversial. We conducte d annual surveys in 1999-2001 to investigate migraine prevalence among a nation -wide sample of 13 426 adolescents aged 13-15 years. Participants from five ju nior high schools around different regions of Taiwan completed selfadministered questionnaires. The diagnosis of migraine was based on the classification criter ia proposed by the International Headache Society, 1988. Data for 23 433 person -years were collected and analysed for trends in prevalence and incidence. The 1-year prevalence of migraine increased 42%during 1999-2001 (from 5.2 to 7.4 %, P < 0.001). This increasing trend was demonstrated in both sexes, all ages, and all but one studied regions of Taiwan. Of note was the biggest increment of prevalence (79%) among 7th graders (students aged 13 years) through these 3 yea rs. Annual incidence rates did not differ between 1999 and 2000 and 2000 and 200 1 (6.1%vs. 5.7%; P=0.4). One-year persistence rates of migraine diagnosis, su rrogates of migraine duration, did not differ between 1999 and 2000 and 2000 and 2001 (34.2%vs. 41.2%; P=0.1). Our study found that the prevalence of migraine was increasing in our sampled adolescents, which results from an increment star ting at age 13 or younger. The prevalence of migraine in Asians might be increas ing, although previous studies showed lower prevalence in this region. Children or adolescents may be more vulnerable to the environmental or societal change.
文摘Aims: To determine the prevalence of serious neurological disorders among chil dren with chronic headache. Methods: All children presenting to a specialist hea dache clinic over seven years with headache as their main complaint were assesse d by clinical history, physical and neurological examination, neuroimaging where indicated, and by follow up using prospective headache diaries. Results: A tota l of 815 children and adolescents (1.25-18.75 years of age, mean 10.8 years (SD 2.9); 432 male) were assessed. Mean duration of headache was 21.2 months (SD 21 .2). Neuroimaging (brain CT or MRI) was carried out on 142 (17.5%) children. Th e vast majority of patients had idiopathic headache (migraine, tension, or uncla ssified headaches). Fifty one children (6.3%) had other chronic neurological di sorders that were unrelated to the headache. The headache in three children (0.3 7%, 95%CI 0.08%to 1.1%)was related to active intracranial pathology which wa s predictable on clinical findings in two children but was unexpected until a la ter stage in one child (0.12%, 95%CI 0.006%to 0.68%). Conclusions: Chronic h eadache in childhood is rarely due to serious intracranial pathology. Careful hi story and thorough clinical examination will identify most patients with serious underlying brain abnormalities. Change in headache symptomatology or personalit y change should lower the threshold for imaging.
