A clinical study of migraines without aura in children : based on revised international headache society criteria

소아 편두통에 대한 임상적 고찰 : 개정된 편두통 진단기준에 근거하여

  • Seo, Bo Gil (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Yoo, Myung Hwan (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jae Won (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jung Yeon (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Hye Lim (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Moon Soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Deok-soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 서보길 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 유명환 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 심재원 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 심정연 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 정혜림 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 박문수 (성균관대학교 의과대학 강북삼성병원 소아과) ;
  • 김덕수 (성균관대학교 의과대학 강북삼성병원 소아과)
  • Received : 2005.08.11
  • Accepted : 2005.10.04
  • Published : 2006.01.15

Abstract

Purpose : Because migraine in children has different characteristics from that in adults, it is inappropriate to apply migraine criteria for adults to children. Recently, the International Headache Society(IHS) revised criteria regarding children's characteristics. Therefore, we reviewed the characteristics of childhood migraines without auras based on the revised criteria and compared the data with the findings of childhood migraine by the previous criteria. Methods : Among 102 children who visited the outpatient clinic of Kangbuk Samsung Hospital for the chief complaint of headache, we analyzed the clinical findings of 34 patients, who were diagnosed as migraine without aura, and probable migraine based on the revised criteria. Results : Migraines without aura were diagnosed in 27 patients(26.5 percent) and probable migraines were observed in seven patients(6.8 percent). The usual duration of headache attacks over 2 hours was observed in 12 patients(44.4 percent). On the contrary, 15 patients(55.6 percent) usually experienced headaches for one to two hours. According to the location of headaches, there were temporal areas in 14 cases, frontal areas in nine cases, occipital areas in two cases and diffuse areas in two cases. The striking point in probable migraines is that the length of headache was below one hour in five patients. Nine patients were diagnosed as migraine without aura, when the first edition criteria was applied to same patients. Conclusion : We found that the prevalence of migraine without aura increased by the revision of IHS criteria. We hope that migraines in children will be diagnosed correctly by the new IHS criteria.

목 적 : 소아에서 비교적 흔한 것으로 알려진 편두통은 성인과 다른 양상을 보이므로 성인의 편두통 진단기준을 그대로 이용하기가 곤란하다. 최근 국제두통학회에서 발표한 새로운 진단기준에 근거하여 전조를 동반하지 않는 편두통 환자의 임상적 특징과 이전의 진단기준 적용시와의 차이점에 대해 알아보고자 하였다. 방 법 : 2003년 9월부터 2004년 7월까지 강북삼성병원 소아과 외래에 두통을 주소로 내원하였던 102명의 환자 중에서 국제두통학회의 개정된 기준에 근거하여 진단 내린 전조를 동반하지 않는 편두통 환자 27명과 진단기준 4가지 중 1가지를 만족시키지 못하는 개연적 편두통 환자 7명을 대상으로 임상적 특징을 분석하고 이전의 편두통 진단기준과 비교분석하였다. 결 과 : 전조를 동반하지 않는 편두통 환자는 27명(26.5%)이었으며 평균 연령은 11.0세, 남녀비는 1.7 : 1이었으며 10명(37.0%)에서 편두통의 가족력이 있었다. 편두통의 기간은 평균 16.3개월이었고 빈도는 한달에 평균 13.1회였으며, 지속시간은 2시간 이상이 12례(44.4%)였고 1-2시간이 15례(55.6%)를 차지하였다. 발생부위는 전두부가 9례, 후두부가 2례, 측두부가 14례였으며, 측두부일 경우 편측성이 11례, 양측성이 3례였고, 양상은 압박성(15례, 55.6%)이 편두통의 전형적인 양상인 박동성(6례, 22.2%)보다 많았다. 개연적 편두통 환자는 7명(6.8%)이었으며, 지속시간이 1시간 미만인 경우가 5명인 것을 제외하고는 그 외의 특징에서 편두통 환자와 비슷한 양상을 보였다. 이전 진단 기준을 동일한 환자들에게 적용했을 때 전조를 동반하지 않는 편두통 환자는 9명(8.8%)으로 개정된 진단기준에서의 27명(26.5%)과 큰 차이를 보였다. 결 론 : 소아 편두통 환자의 임상적 특징을 알아보았으며, 이전의 진단기준과 비교하였을 때 새로 개정된 진단 기준에서 지속시간을 1시간 이상, 부위를 양측성까지 포함시킴으로써 상당수의 환자들이 편두통으로 진단될 수 있었다.

Keywords

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