Characterization of chronic daily headaches in children in a multidisciplinary headache center
Characterization of chronic daily headaches in children in a multidisciplinary headache center
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DOI：
10.1212/wnl.56.8.1032
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发表时间：
2001-04-24
期刊：
影响因子：
9.9
通讯作者：
deGrauw, TJ
中科院分区：
文献类型：
--
作者：
Hershey, AD;Powers, SW;deGrauw, TJ
背景：超过 4% 的成年人患有慢性日常头痛 (CDH)。然而，CDH 的标准存在争议。在儿童中，频繁头痛和 CDH 的特征是有限的。方法：建立了一个头痛中心来表征儿童（3 至 18 岁）头痛的特征。 34 个月内，577 名儿童接受了评估。根据每月头痛次数大于或等于 15 次的定义，200 名 (34.6%) 儿童患有 CDH。结果：这些儿童首次头痛的平均年龄为 9.3 +/- 3.6 岁，而到头痛中心就诊的平均年龄为 12.5 +/- 3.1 岁。 68% 是女孩，88% 是白人，11% 是非裔美国人。 92% 的人临床上患有偏头痛，而 60.5% 的人符合国际头痛协会偏头痛标准。 79% 的人感到搏动性疼痛，63.5% 的人有恶心伴或不伴呕吐的症状，59.5% 的人有畏光和恐声症。出现了三个子类别，其中 37% 的人经常头痛，但不是每天都会头痛，43.5% 的人每天都会头痛，19.5% 的人有持续性头痛。结论：儿童 CDH 的特征与偏头痛最接近。使用频率将这些儿童明确划分为三组：频繁头痛（15 至 29 次）、每天间歇性头痛和每天连续性头痛。每日连续组最为独特；然而，这些头痛的性质仍然是偏头痛。
Background: Chronic daily headaches (CDH) occur in >4% of the adult population. The criteria for CDH, however, are controversial. In children, the characterization of frequent headaches and CDH is limited. Methods: A Headache Center to characterize headaches in children (3 to 18 years old) was established. Over 34 months, 577 children have been evaluated. With use of a definition of greater than or equal to 15 headaches per month, 200 (34.6%) children had CDH. Results: The average age at the first headache in these children was 9.3 +/- 3.6 years, whereas the average age at presentation to the Headache Center was 12.5 +/- 3.1 years. Sixty-eight percent were girls, 88% were Caucasian, and 11% were African American. Ninety-two percent clinically had migraine headaches, whereas 60.5% met the International Headache Society migraine criteria. The pain was pulsatile in 79%, 63.5% had nausea with or without vomiting, and 59.5% had photophobia and phonophobia. Three subcategories emerged, with 37% having frequent headaches but not daily, 43.5% having episodic daily headaches, and 19.5% having a continuous headache. Conclusions: The features of CDH in children most closely match those of migraine. A clear division of these children using frequency identifies three groups: frequent headaches (15 to 29), daily intermittent, and daily continuous. The daily continuous group is the most unique; however, the nature of these headaches continues to remain migrainous.