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Yıl:2003; Cilt: 16; Sayı: 3>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2003;16(3):157-164
Çocukluk çağı migreni ve diğer episodik başağrıları
HM Selekler, K Babaoğlu, S Komsuoğlu
Çocukluk çağı migreni yaşa ilişkin özellikler taşır. Uluslararası Başağrısı Derneği (International Headache Society; IHS) her ne kadar 15 yaşın altındaki çocuklar için atak süresinde modifikasyon yapmış olsa da yeterli görülmemektedir. Bu çalışmada, klinik olarak migren düşünülen ve diğer tip episodik başağrısı bulunan hastalar IHS kriterlerine göre sınıflandırılmaya çalışılmıştır. Pediatri polikliniğince "primer başağrısı" ön tanısı ile Nöroloji kliniği "başağrısı polikliniğine" yönlendirilen, 19 yaşından gün almamış, episodik tipte başağrısı bulunan 41 hasta IHS kriterlerine göre sınıflandırılmaya çalışılmıştır. Hastaların yaş ortalaması 13.92±3.28 olup; min. 7, max.18 idi. IHS kriterlerine göre 19 hasta "migren", 15 hasta "migrenöz başağrısı", 1 hasta "episodik gerilim başağrısı", 6 hasta "sınıflandırılamayan başağrısı" olarak gruplandırıldı. Çocuklardaki migren semptomları gelişimsel faktörlerin bir fonksiyonu olduğu için, aşikar migrenli çocuklar bile migren kriterlerini karşılamayabilirler. Çocukluk çağı başağrılarındaki en onemli sorun, spesifite ve sensitivite arasındaki hassas dengenin sağlanabilmesi gibi görünmektedir
Childhood migraine has peculiarities related to age. Although International Headache Society (IHS) has modified the attack duration criteria for children under 15 [year]s old; this modification does not seem to be satisfactory. In this study, patients who were clinically considered to have migraine and patients with other types of episodic headaches were classified according to IHS criteria. Forty one patients, not younger than 19 [year]s old, with episodic type headaches who were directed to headache outpatient clinic of Neurology department, considered to have a "primary headache disorder", put forward during the preliminary diagnosis by the Pediatrics outpatient clinic were classified according to IHS criteria. Mean age was 13.92±3.28; min. 7, max. 18. Patients were classified according to IHS criteria; 19 had "migraine" headache, 15 had "migrainous headache", 1 had "episodic tension-type headache" and 6 had "unclassified headaches". As the migraine symptoms in children are a function of the developmental factors, even children with overt migraine could not meet migraine criteria. In childhood headaches, the most important problem seems to be setting a delicate balance between sensitivity and specifity.

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