PEDIATRIC MIGRAINE - 10/09/11
Résumé |
A child with an acute migraine headache presents multiple challenges to the emergency physician. The dilemma of the differential diagnosis, the anxiety of the child and parent about the nature of the headache, and the difficulty of choosing effective treatment demand the emergency physician's full clinical acumen.
The prevalence of headache in children is more common than many physicians realize, and the age at which migraine headaches begin is earlier than is usually appreciated. In a study of more than 9000 children in Sweden over a 14-year period, Bille 7 found that 40% had experienced a headache by age 7, and this rose to 75% by age 15. Five percent had experienced a migraine by age 15. Mortimer 21 described 1083 children with headache in a British general practice: 4.7% of boys and 5% of girls experienced migraine. Of those with migraine, 26.4% had experienced onset by age 4 years, 45.3% by 5 years, 66.0% by 7 years, and 98.1% by 9 years. In a headache clinic in Israel, migraine accounted for up to 54% of the headaches seen in children. 24 Of children presenting to a pediatric emergency unit with a complaint of migraine-like symptoms, 30% had a prior visit for the same complaint, and only 50% had no prior history of a migraine-like illness. 27
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| Address reprint requests to Charles Welborn, MD, FACEP Pediatric Emergency Services Harlem Hospital Center 506 Lenox Avenue New York, NY 10037 |
Vol 15 - N° 3
P. 625-636 - août 1997 Retour au numéro
Article précédent
- APPROACH TO GENERALIZED WEAKNESS AND PERIPHERAL NEUROMUSCULAR DISEASE
- Frank LoVecchio, Sheldon Jacobson
- SPELLS : Differential Diagnosis and Management Strategies
- Chris Preblick–Salib, Andy Jagoda
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