1
|
Bouloux GF, Chou J, DiFabio V, Ness G, Perez D, Mercuri L, Chung W, Klasser GD, Bender SD, Kraus S, Crago CA. Guidelines for the Management of Patients With Orofacial Pain and Temporomandibular Disorders. J Oral Maxillofac Surg 2024:S0278-2391(24)00200-3. [PMID: 38643965 DOI: 10.1016/j.joms.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024]
Affiliation(s)
- Gary F Bouloux
- Family Professor, Division Chief, Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Joli Chou
- Associate Professor, Department Of Oral and Maxillofacial Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Vince DiFabio
- Associate Clinical Professor, Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, University of Maryland Medical Center, Baltimore, MD
| | - Greg Ness
- Emeritus Professor-Clinical, The Ohio State University, Private Practice, Oral and Facial Surgery for Adults and Children, Columbus, OH
| | - Daniel Perez
- Associate Professor and Program Director, Oral and Maxillofacial Surgery, University Texas Health Sciences San Antonio, San Antonio, TX
| | - Louis Mercuri
- Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL
| | - William Chung
- Clinical Professor, Residency Program Director, Indiana University School of Dentistry and Hospital Medicine, Indianapolis, IN
| | - Gary D Klasser
- Certificate Orofacial Pain, Professor, Louisiana State University Health Sciences Center, School of Dentistry, New Orleans, LA
| | - Steven D Bender
- Clinical Associate Professor, Director, Clinical Center for Facial Pain and Sleep Medicine, Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, TX
| | | | | |
Collapse
|
2
|
Temporomandibular Joint Surgery. J Oral Maxillofac Surg 2023; 81:E195-E220. [PMID: 37833023 DOI: 10.1016/j.joms.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
|
3
|
Lynge S, Vach W, Dissing KB, Hestbaek L. Potential effect modifiers for treatment with chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7-14 years: development of and results from a secondary analysis of a randomised clinical trial. Chiropr Man Therap 2023; 31:20. [PMID: 37434189 PMCID: PMC10337090 DOI: 10.1186/s12998-023-00492-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND A recent randomized controlled trial (RCT) investigating the effect of chiropractic manipulation in 199 children aged 7-14 years with recurrent headaches demonstrated a significant reduction of number of days with headache and a better global perceived effect (GPE) in the chiropractic manipulation group compared to a sham manipulation group. However, potential modifiers for the effectiveness of chiropractic manipulation of children with recurrent headaches have never been identified. The present study is a secondary analysis of data from that RCT and will investigate potential effect modifiers for the benefit of chiropractic manipulation for children with headache. METHODS Sixteen potential effect modifiers were identified from the literature and a summary index was prespecified based on clinical experience. Relevant variables were extracted from baseline questionnaires, and outcomes were obtained by means of short text messages. The modifying effect of the candidate variables was assessed by fitting interaction models to the data of the RCT. In addition, an attempt to define a new summary index was made. RESULTS The prespecified index showed no modifying effect. Four single variables demonstrated a treatment effect difference of more than 1 day with headache per week between the lower and the upper end of the spectrum: intensity of headache (p = 0.122), Frequency of headache (p = 0.031), sleep duration (p = 0.243), and Socioeconomic status (p = 0.082). Five variables had a treatment effect difference of more than 0.7 points on the GPE scale between the lower and the upper end of the spectrum: Frequency of headache (p = 0.056), Sport activity (p = 0.110), Sleep duration (p = 0.080), History of neck pain (p = 0.011), and Headache in the family (0.050). A new summary index could be constructed giving highest weight to History of neck pain and Headache in the family and Frequency of headache. The index suggests a difference of about 1 point in GPE between low and high values of the index. CONCLUSION Chiropractic manipulation offers a moderate benefit for a broad spectrum of children. However, it cannot be excluded that specific headache characteristics, family factors, or a history of neck pain may modify the effect. This question must be addressed in future studies. TRIAL REGISTRATION ClinicalTrials.gov (Albers et al in Curr Pain Headache Rep 19:3-4, 2015), identifier NCT02684916, registered 02/18/2016-retrospectively registered.
Collapse
Affiliation(s)
- Susanne Lynge
- Private Chiropractic Practice, Vivaldisvej 6, 9700, Broenderslev, Denmark
| | - Werner Vach
- The Chiropractic Knowledge Hub, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
- Basel Academy for Quality and Research in Medicine, Steinenring 6, 4051, Basel, Switzerland
| | - Kristina Boe Dissing
- The Chiropractic Knowledge Hub, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Lise Hestbaek
- The Chiropractic Knowledge Hub, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense C, Denmark.
| |
Collapse
|
4
|
Dissing KB, Vach W, Lynge S, Christensen HW, Hestbaek L. Description of recurrent headaches in 7-14-year-old children: Baseline data from a randomized clinical trial on effectiveness of chiropractic spinal manipulation in children with recurrent headaches. Chiropr Man Therap 2023; 31:5. [PMID: 36717833 PMCID: PMC9887886 DOI: 10.1186/s12998-023-00479-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Headaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally. METHODS Baseline data for a clinical trial included a questionnaire and a physical screening. Children's characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a "non-classifiable" group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index. RESULTS 253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups. CONCLUSIONS Children with recurrent headaches are often severely affected. A questionnaire-based classification appeared feasible to distinguish between migraine and tension-type headaches in children but leaving many children unclassified. A migraine-tension-type-index can be generated allowing to regard the traditional distinction as a continuum (including mixed headache), and potentially serving as an instrument to improve headache management. Trial registration ClinicalTrials.gov, identifier NCT02684916.
Collapse
Affiliation(s)
| | - Werner Vach
- grid.10825.3e0000 0001 0728 0170Chiropractic Knowledge Hub, Campusvej 55, 5230 Odense M, Denmark ,Basel Academy, Spalenring 145, 4055 Basel, Switzerland
| | - Susanne Lynge
- Private Practice, Vivaldisvej 6, 9700 Brønderslev, Denmark
| | - Henrik Wulff Christensen
- grid.10825.3e0000 0001 0728 0170Chiropractic Knowledge Hub, Campusvej 55, 5230 Odense M, Denmark
| | - Lise Hestbaek
- grid.10825.3e0000 0001 0728 0170Chiropractic Knowledge Hub, Campusvej 55, 5230 Odense M, Denmark ,grid.10825.3e0000 0001 0728 0170University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| |
Collapse
|
5
|
Kilic B. Evaluation of the Etiology, Clinical Presentation, Findings and Prophylaxis of Children with Headache. SISLI ETFAL HASTANESI TIP BULTENI 2021; 55:128-133. [PMID: 33935547 PMCID: PMC8085460 DOI: 10.14744/semb.2019.36604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 04/15/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES A headache is prevalent in childhood and constitutes a significant part of outpatient applications. This study aimed to evaluate the results of etiology, clinical features, examination results, prophylactic treatment and follow-up in patients with a headache. METHODS Between January 2017 and December 2018, the files of the patients with the complaint of headache were reviewed retrospectively in this study. A headache was classified according to the International Headache Society (IHS) criteria. RESULTS In this study, 350 patients aged between 3-17 years old and the mean age of 11.2±2.7 with a headache were included; 212 (60.6%) of them was female and 138 (39.4%) of them was male. The rate of a primary headache was higher in females than in males (p=0.004). The headache causes were a migraine in 51.1%, tension-type headache in 32.3%, secondary in 13.4%, and not classified in 3.1%. The mean age of the patients with a primary headache was significantly higher than patients with a secondary headache (p<0.001). The most common trigger factor was insomnia (52.7%). Abnormal physical/neurological signs and symptoms were detected in 17 (9.49%) patients. Cranial magnetic resonance imaging (MRI) examination was performed in 121 (34.5%) patients. Abnormal findings were found in 35 (28.9%) of these. In this study, 33 patients underwent electroencephalography (EEG); none of the had an epileptiform abnormality. Flunarizine (23.2%) and cyproheptadine (7.5%) were the most administered prophylactic treatments. It was observed that all patients who had prophylaxis and who had come to control had a significant decrease in headaches. CONCLUSION The cause of childhood headaches is mostly migraine and tension-type headache. As long as there is no abnormality in the history and neurological examination, neuroimaging studies are not required in the routine evaluation of patients with a headache. Prophylactic treatment increases the quality of life in selected cases.
Collapse
Affiliation(s)
- Betul Kilic
- Department of Pediatric Neurology, University of Health Sciences Turkey Faculty of Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| |
Collapse
|
6
|
Lynge S, Dissing KB, Vach W, Christensen HW, Hestbaek L. Effectiveness of chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7-14 years - a randomised clinical trial. Chiropr Man Therap 2021; 29:1. [PMID: 33413519 PMCID: PMC7792176 DOI: 10.1186/s12998-020-00360-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Background To investigate the effectiveness of chiropractic spinal manipulation versus sham manipulation in children aged 7–14 with recurrent headaches. Methods Design: A two-arm, single-blind, superiority randomised controlled trial. Setting: One chiropractic clinic and one paediatric specialty practice in Denmark, November 2015 to August 2020. Participants: 199 children aged 7 to 14 years, with at least one episode of headache per week for the previous 6 months and at least one musculoskeletal dysfunction identified. Interventions: All participants received standard oral and written advice to reduce headaches. In addition, children in the active treatment group received chiropractic spinal manipulation and children in the control group received sham manipulation for a period of 4 months. Number and frequency of treatments were based on the chiropractor’s individual evaluation in the active treatment group; the children in the control group received approximately eight visits during the treatment period. Primary outcome measures: ‘Number of days with headache’, ‘pain intensity’ and ‘medication’ were reported weekly by text messages, and global perceived effect by text message after 4 months. A planned fixed sequence strategy based on an initial outcome data analysis was used to prioritize outcomes. ‘Number of days with headache’ and ‘pain intensity’ were chosen as equally important outcomes of highest priority, followed by global perceived effect and medication. The significance level for the first two outcomes was fixed to 0.025 to take multiplicity into account. Results Chiropractic spinal manipulation resulted in significantly fewer days with headaches (reduction of 0.81 vs. 0.41, p = 0.019, NNT = 7 for 20% improvement) and better global perceived effect (dichotomized into improved/not improved, OR = 2.8 (95% CI: 1.5–5.3), NNT = 5) compared with a sham manipulation procedure. There was no difference between groups for pain intensity during headache episodes. Due to methodological shortcomings, no conclusions could be drawn about medication use. Conclusions Chiropractic spinal manipulation resulted in fewer headaches and higher global perceived effect, with only minor side effects. It did not lower the intensity of the headaches. Since the treatment is easily applicable, of low cost and minor side effects, chiropractic spinal manipulation might be considered as a valuable treatment option for children with recurrent headaches. Trial registration ClinicalTrials.gov, identifier NCT02684916, registered 02/18/2016 – retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-020-00360-3.
Collapse
Affiliation(s)
- Susanne Lynge
- Private Chiropractic Practice, Vivaldisvej 6, 9700, Broenderslev, Denmark
| | - Kristina Boe Dissing
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Werner Vach
- Nordic Institute for Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.,Basel Academy, Steinenring 6, 4054, Basel, Switzerland
| | - Henrik Wulff Christensen
- Nordic Institute for Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.,Private Chiropractic Practice, Enghavevej 2, 5800, Nyborg, Denmark
| | - Lise Hestbaek
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. .,Nordic Institute for Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.
| |
Collapse
|
7
|
Nguyen T, Pavitt S, Wusthoff C, Rassbach C. Breaking a Cycle of Dependence to Improve Neurology Education: A Qualitative Study Exploring Pediatric Residents' Perspectives. Clin Pediatr (Phila) 2019; 58:1158-1165. [PMID: 31455089 DOI: 10.1177/0009922819870557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. To understand pediatric residents' experiences and attitudes toward learning neurology; and to identify facilitators and barriers to learning neurology during residency. Study Design. Qualitative study using focus groups of pediatric residents at Stanford during November 2017. Focus groups were audio-recorded and transcribed verbatim. Investigators independently coded the transcripts and reconciled codes to develop themes using constant comparison associated with grounded theory. Results. Eighteen pediatric residents participated in 3 focus groups. Four themes emerged: (1) residents feel unprepared and uncomfortable; (2) intrinsic and extrinsic factors contribute to residents' dependence on neurologists; (3) residents desire more teaching; and (4) residents are motivated to overcome their dependence on neurologists and optimize their learning. Conclusion. Pediatric residents are motivated to acquire more skills to assess and manage patients with neurological conditions. They recognize key factors that contribute to a cycle of dependence that impedes their learning and offer strategies to overcome these barriers.
Collapse
|
8
|
The Relationship between Infant Colic and Migraine as well as Tension-Type Headache: A Meta-Analysis. Pain Res Manag 2019; 2019:8307982. [PMID: 31316683 PMCID: PMC6604354 DOI: 10.1155/2019/8307982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/25/2019] [Accepted: 05/09/2019] [Indexed: 01/01/2023]
Abstract
Background Infant colic is a common benign disease during early infancy. Migraine and tension-type headache (TTH) are the most common primary headache forms among pediatric population. Several studies have investigated the incidence of infant colic in patients with migraine and TTH. The meta-analysis was to assess the relationship between infant colic and migraine as well as TTH. Methods PubMed, Web of Science, and Cochrane Library were searched until August 16, 2018, for potential studies. Data were extracted by two independent authors and analyzed using RevMan 5.2 software. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the association between infant colic and migraine as well as TTH, respectively. Results A total of 148 studies were found, and 7 studies were finally included. A higher incidence of colic during infancy was revealed in migraine patients than controls (P=0.05, OR: 2.51, 95% CI: 1.32-4.77) and TTH subjects (P=0.02, OR: 0.33, 95% CI: 0.13-0.86), respectively. And no significances were found between TTHs with controls (P=0.51, OR: 1.17, 95% CI: 0.73-1.89). Conclusion This meta-analysis indicated that migraine was associated with increased incidence of infantile colic history, but TTH incidence was not relevant with the incidence of infantile colic history.
Collapse
|
9
|
Evaluation of Pain Syndromes, Headache, and Temporomandibular Joint Disorders in Children. Oral Maxillofac Surg Clin North Am 2018; 30:11-24. [PMID: 29153234 DOI: 10.1016/j.coms.2017.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
After a thorough review of the history and presentation of a child's facial pain, a targeted head and neck examination is critical to the appropriate diagnosis of facial pain and temporomandibular joint disorders. It is critical to distinguish between the structural (trauma, degenerative disease, and tumor) and nonstructural (neurogenic, myogenic, and psychological) causes of pain, which will allow for incorporation of appropriate strategies of medical, psychological, dental, and surgical therapies.
Collapse
|
10
|
Sheridan DC, Meckler GD. Inpatient Pediatric Migraine Treatment: Does Choice of Abortive Therapy Affect Length of Stay? J Pediatr 2016; 179:211-215. [PMID: 27634627 DOI: 10.1016/j.jpeds.2016.08.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/21/2016] [Accepted: 08/16/2016] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To describe the inpatient management of pediatric migraine and the association between specific medications and hospital length of stay (LOS). STUDY DESIGN Historical cohort study review of patients age <19 years of age admitted to a single tertiary care children's hospital between 2010 and 2015 for treatment of migraine headache. RESULTS The cohort consisted of 58 encounters with an average patient age of 14.3 years (SD 3.2 years) with a female predominance (62%). The mean number of inpatient medications received by patients was 3 (range 1-7), with dopamine antagonists and dihydroergotamine used most commonly (67% and 59% of encounters, respectively). The average LOS was 56 hours (95% CI 48.2-63.2) and did not vary by medication received, although patients who received an opioid had a significantly longer LOS (79.2 vs 47.9 hours respectively; P < .001). CONCLUSIONS Children admitted to the hospital for treatment of migraine headache frequently require a large number of medications over an average hospital LOS of more than 2 days without apparent differences based on medication received other than prolonged stays for subjects who received opioids.
Collapse
Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.
| | - Garth D Meckler
- Department of Pediatrics, Pediatric Emergency Medicine, University of British Columbia BC Children's Hospital, Vancouver, British Columbia, Canada
| |
Collapse
|
11
|
Bekan G, Tfelt-Hansen P. Is the Generally Held View That Intravenous Dihydroergotamine Is Effective in Migraine Based on Wrong "General Consensus" of One Trial? A Critical Review of the Trial and Subsequent Quotations. Headache 2016; 56:1482-1491. [PMID: 27595607 DOI: 10.1111/head.12904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/22/2016] [Accepted: 07/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The claim that parenteral dihydroergotamine (DHE) is effective in migraine is based on one randomized, placebo-controlled, crossover trial from 1986. The aim of this review was to critically evaluate the original article. It was also found to be of interest to review quotes concerning the results in the more than 100 articles subsequently referring to the article. METHODS The correctness of the stated effect of intravenous DHE in the randomized clinical trial (RCT) was first critically evaluated. Then, Google Scholar was searched for references to the article and these references were classified as to whether they judged the reported RCT as positive or negative. RESULTS The design of the RCT, with a crossover within one migraine attack, only allows evaluation of the results for the first period and the effect of DHE and placebo were quite comparable. About 151 references were found for the article in Google scholar. Among the 95 articles with a judgment on the efficacy of intravenous DHE in the RCT, 90 stated that DHE was effective or likely effective whereas only 5 articles stated that DHE was ineffective. CONCLUSIONS Despite a "negative" RCT, authors of subsequent articles on the efficacy of parenteral DHE overwhelmingly reported this RCT as "positive." This is probably due to the fact that the authors concluded in the abstract that DHE is effective, and to a kind of "wrong general consensus."
Collapse
Affiliation(s)
- Goran Bekan
- Department of Neurology, North Zealand Hospital in Hillerød, Hillerød, Denmark
| | - Peer Tfelt-Hansen
- Department of Neurology, Zealand University Hospital, Roskilde, Denmark.
| |
Collapse
|
12
|
Abstract
Chronic daily headache (CDH) is a group of headache disorders, in which headaches occur daily or near-daily (>15 days per month) and last for more than 3 months. Important CDH subtypes include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache. Other headaches with shorter durations (<4 h/day) are usually not included in CDH. Common comorbidities of CDH are medication overuse headache and various psychiatric disorders, such as depression and anxiety. Indications of inpatient treatment for CDH patients include poor responses to outpatient management, need for detoxification for overuse of specific medications (particularly opioids and barbiturates), and severe psychiatric comorbidities. Inpatient treatment usually involves stopping acute pain, preventing future attacks, and detoxifying medication overuse if present. Multidisciplinary integrated care that includes medical staff from different disciplines (e.g., psychiatry, clinical psychology, and physical therapy) has been recommended. The outcomes of inpatient treatment are satisfactory in terms of decreasing headache intensity or frequency, withdrawal from medication overuse, reducing disability, and improving life quality, although long-term relapse is not uncommon. In conclusion, inpatient treatment may be useful for select patients with refractory CDH and should be incorporated in a holistic headache care program.
Collapse
|
13
|
Genizi J, Khourieh Matar A, Zelnik N, Schertz M, Srugo I. Frequency of pediatric migraine with aura in a clinic-based sample. Headache 2015; 56:113-7. [PMID: 26790850 DOI: 10.1111/head.12741] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the prevalence and risk factors for pediatric migraine with aura (MWA) among patients presenting to pediatric neurology clinics. BACKGROUND Headache is a common complaint among children, and the prevalence of migraine is about 8%. Up to one third of adults with migraine report experiencing aura; however, the exact percentage in children is unknown. METHODS Medical records of children presenting with headache to three pediatric neurology clinics in Haifa in the last 5 years were retrospectively reviewed. Inclusion criteria were a diagnosis of migraine headache at 5-18 years of age. RESULTS Of 260 children (140 female) who had migraine, 26.2% experienced aura. MWA was more common among females compared to males (32.6% vs 18.9%, P < .01) and among older children (OR: 2.50, 95% CI: 1.20-5.20; P < .01). Among those who experienced aura, visual aura was more common in females than males (66.7% vs 33.3%, P < .04). Family history of migraine was strongly related to MWA (P < .02): the odds of MWA were 2.46 times greater in children who had a family history of migraine. (OR: 2.46, 95% CI: 1.08-5.62; P < .03). CONCLUSIONS MWA is as common in children as in adults. Aura is more common in older children. Children who have MWA are more likely to have a family history of migraine.
Collapse
Affiliation(s)
- Jacob Genizi
- Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel.,Pediatric Neurology Unit, Bnai Zion Medical Center, Haifa, Israel.,Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | - Nathanel Zelnik
- Pediatric Neurology Unit, Carmel Medical Center, Haifa, Israel.,Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mitchell Schertz
- Child Development & Pediatric Neurology Service, Meuhedet - Northern Region, Haifa, Israel
| | - Isaac Srugo
- Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel.,Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel
| |
Collapse
|