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The validity of the criteria used to diagnose migraine in the paediatric age
INTRODUCTION. The diagnosis of migraine is based entirely on clinical data, and generally accepted and valid criteria should be applied as a common diagnostic reference. AIMS. The aim of this work was to study the epidemiological and clinical characteristics of migraine in the paediatric age and to analyse the validity of the criteria used in its diagnosis.
PATIENTS AND METHODS. A total of 290 histories of patients with recurring headaches (150 with migraine and 140 with non-migraine headaches) were reviewed, epidemiological and clinical data were collected, and complementary examinations were performed, when necessary. The sensitivity, specificity and likelihood ratio of the Vahlsquit, Prensky and IHS criteria for migraine were all calculated.
RESULTS. 32% of cases were migraines with aura. The age of onset of migraine was 8.7±2.9 years, with no differences between sexes. Nevertheless, in migraine with aura the age of onset (9.8±3.3 years) and prevalence of females (63.3%) were significantly higher (p < 0.05). Family history was positive in 77.3% of the cases. In migraine, the pain was unilateral (44.4%) or bilateral (55.6%), throbbing (93.7%), interrupted daily activities (63.2%), got worse on doing exercise (68.1%) and was accompanied by nausea (70.1%) and sensitivity to light and sound (66.2%). The throbbing quality, vomiting, one-sidedness and moderate to severe intensity were the items that displayed the greatest discriminating capacity and the IHS criteria were those with the highest diagnostic validity. Diagnosis was not altered by the complementary examinations.
CONCLUSIONS. Migraine is a common pathology among children in the paediatric age and generally begins in the school age. The IHS criteria allow it to be diagnosed, although monitoring its progress would be the reference test with which to validate the diagnostic criteria.
HeadacheInfancyMigraineCefalea y MigrañaDolor