소아기 편두통(Childhood Migraine)에 대한 임상적 고찰

Abstract

Chronic headache is one of the most common symptom in childhood disease and migraine is the second or third common cause of childhood headache. But pediatricians have difficulties in making diagnosis and management in migraine headache in children despite elaborate diagnostic procedure because children couldn't describe their own symptoms accurately.

In this study, we evaluated the clinical characteristics of childhood migraine by careful history thking, physical and neurologic examination, EEG and radiologic neuroimaging study, if needed.

Thirty patients were diagnosed as migraine at the department of pediatrics, Asan Medical Center July 1992 to December 1994. The patients were divided into three groups. One group included 16 cases who were not treated and another group had 6 cases who were treated with acetaminophen and the other group had 7 cases who were treated with acetaminophen and β-blocker.

There were 30 cases in 12 males(40%) and 18 females(60%) in series and average age was 11.6 years ranging from 7 years to 15 years. The classification of migraine were common migraine(46.7%), classic migraine(36.7%) and basilar migraine(16.7%). The locations of headache were temporal(43.3%), frontal(26.7%) and occipital(3.3%). Unilateral headache were 10 cases(33.3%). The associated symptoms were nausea(73.3%), vomiting(40%), pallor(23.3%), abdominal pain(16.7%) and ocular pain(16.7%). There were 13 auras and 18 positive family histories. The nature of headache were throbbing(46.7%), heaviness(13.3%) and sharp pain(6.7%). The relieving factors were sleep(36.7%) and rest(23.3%). Acetaminophen and β-blocker could reduce headache in more than fifty percentages of treated patients. However, counselling alone could reduce headache, also.

We concluded that migraine was one of the most common cause of childhood headache and responded well to acetaminophen and β-blocker. More than one half underwent spontaneous remission after several months or years after counselling.

Chronic headache is one of the most common symptom in childhood disease and migraine is the second or third common cause of childhood headache. But pediatricians have difficulties in making diagnosis and management in migraine headache in children despite elaborate diagnostic procedure because children couldn't describe their own symptoms accurately.

In this study, we evaluated the clinical characteristics of childhood migraine by careful history thking, physical and neurologic examination, EEG and radiologic neuroimaging study, if needed.

Thirty patients were diagnosed as migraine at the department of pediatrics, Asan Medical Center July 1992 to December 1994. The patients were divided into three groups. One group included 16 cases who were not treated and another group had 6 cases who were treated with acetaminophen and the other group had 7 cases who were treated with acetaminophen and β-blocker.

There were 30 cases in 12 males(40%) and 18 females(60%) in series and average age was 11.6 years ranging from 7 years to 15 years. The classification of migraine were common migraine(46.7%), classic migraine(36.7%) and basilar migraine(16.7%). The locations of headache were temporal(43.3%), frontal(26.7%) and occipital(3.3%). Unilateral headache were 10 cases(33.3%). The associated symptoms were nausea(73.3%), vomiting(40%), pallor(23.3%), abdominal pain(16.7%) and ocular pain(16.7%). There were 13 auras and 18 positive family histories. The nature of headache were throbbing(46.7%), heaviness(13.3%) and sharp pain(6.7%). The relieving factors were sleep(36.7%) and rest(23.3%). Acetaminophen and β-blocker could reduce headache in more than fifty percentages of treated patients. However, counselling alone could reduce headache, also.

We concluded that migraine was one of the most common cause of childhood headache and responded well to acetaminophen and β-blocker. More than one half underwent spontaneous remission after several months or years after counselling.