Gülhis DEDA, Mehpare ÖZKAN, Serap TEBER TIRAŞ

Çocukluk Çağı Migren ve Gerilim Tipi Baş Ağrılarında Klinik Özellikler, Risk Faktörleri ve İzlem

Giriş ve Amaç: Baş ağrısı, hastaların yaşam kalitesini etkileyen ve pediyatri pratiğinde sık karşılaşılan hastalıklardan biridir. Bu çalışmada çocukluk ve ergenlikte migren ve gerilim tipi baş ağrısında ayırıcı tanı, predispozan faktörler, klinik izlem ve tedavinin önemini vurgulamak istedik.Materyal ve Metod: Ankara Üniversitesi Tıp Fakültesi Çocuk Nörolojisi Bilim Dalına Haziran 2007-Temmuz 2008 tarihleri arasında baş ağrısı nedeniyle başvuran hastalar içinde migren tanısı konulan 50 hasta, gerilim tipi baş ağrısı tanısı konulan 50 hasta çalışmaya alınmıştır. Migren ve gerilim tipi baş ağrısı tanısı Uluslararası Baş Ağrısı Derneği’nin “Baş Ağrısı Bozukluklarının Uluslararası Sınıflandırması” temel alınarak konulmuştur. Çalışmaya katılan tüm çocukların demografik ve klinik verileri prospektif olarak toplanmıştır.Bulgular: Tüm hastaların 60’ı kız olup cinsiyet açısından karşılaştırıldığında migren ve gerilim tipi baş ağrısı hastaları arasında anlamlı fark bulunmadı. Hastaların yaş ortalaması 11.81±3.05 (5-16) yıl olup, gerilim tipi baş ağrısı grubunda migren grubuna göre yaş ortalaması istatistiksel olarak anlamlı derecede daha yüksekti (13.00±2.37 yıl ve 10.62±3.21 yıl). Ailede baş ağrısı öyküsü migren grubunda %52, gerilim tipi baş ağrısı grubunda %18 olarak bulundu. Otuz altı hasta (17 migren, 19 gerilim tipi baş ağrısı hastası) ağrıyı tetikleyici faktör bildirdi. Otuz dört migren hastasına ve 13 gerilim tipi baş ağrısı hastasına günlük koruyucu tedavi başlandı.Sonuç: Aile öyküsü migren grubunda yüksek risk faktörü olarak bulunurken her iki grupta da tetikleyici faktör oranları benzer bulunmuştu ve stres en sık bildirilen faktördü. Koruyucu tedavi başlanan 47 hastanın ağrı sıklığı ve şiddeti azaldı. Baş ağrısı; yaşam kalitesini etkileyen kronik bir hastalıktır ve ayırıcı tanısı, klinik izlem ve tedavisi önemlidir.

Anahtar Kelimeler:

Çocuk, birincil baş ağrısı, migren, gerilim tipi baş ağrısı

CLINICAL FEATURES, PREDISPOSING FACTORS AND MONITORING IN PEDIATRIC MIGRAINES AND TENSION TYPES HEADACHES

Introduction: Headache is an ailment which has a major impact on the patients’ quality of life and is frequently encountered in the practice of pediatrics. We wanted to emphasize the importance of differential diagnosis, predisposing factors, clinical features and treatment of migraines and tension type headache in children and adolescents in this study. Material and Method: The study involved 50 patients having migraine and 50 tension type headache patients consecutively diagnosed in our pediatric neurology clinic between June 2007 and June 2008. The diagnosis was formulated in a manner based on ‘’International Classification of Headache Disorders’’ criteria published by International Headache Society. Demographic and clinical data were collected prospectively on all children. Results: There were 60 girls of all patients and no significant difference between migraine and tension type headache patients in terms of gender. Mean age was 11.81±3.05 years in all over; while mean age was significantly higher in tension type headache group than migraine group, those given in respectively (13.00±2.37 years v.s. 10.62±3.21 years). A positive family history has 52% migraine group and 18% tension type headache group. Thirty-six patients (17 migraine, 19 tension type headache patiens) reported precipitating factors. Thirty-four migraine patients and 13 tension type headache patients treated with daily prophylaxis agents.Conclusion: While family history is found to be a high risk factor for migraine group, the triggering factor rates have been found to be similar in both groups and stress is the most frequently indicated factor. The frequency and intensity of headaches in 47 patients, in the early stages of protective treatment, were lessened. Headache is a chronic illness that has an impact on patients’ quality of life and its differential diagnosis, clinical features, and treatment are crucial

Keywords:

Children, primer headache, migrain, tension type headache,

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