Classification criteria and distinction between migraine and tensiontype headache in children Ppt Powerpoint Presentation slides D.ssa Livia Rossi Medical Slideshow Migraine Symptoms - Migraine Headaches and Other Neurological ...

Classification criteria and distinction between migraine and tensiontype headache in children

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Slide 1 :

Classification criteria and distinction between migraine and tension-type headache in children Livia N Rossi, I Cortinovis, L Menegazzo, G Brunelli, A Bossi, M Macchi University of Milan Developmental Medicine and Child Neurology 2001, 43: 45-51

Slide 2 :

Introduction In 1988 the International Headache Society (IHS) defined a classification of Headache Disorders, in which the two most important forms are migraine with or without aura (resp. MA and MO) and tension-type headache (TTH). Various authors proposed modifications of the criteria for paediatric age, in order to increase the sensitivity of the MO form. In 1995 a specific revision of the IHS criteria for the diagnosis of MO was proposed by Seshia et al.

Slide 3 :

Purpose of this study Comparison of the IHS criteria with the proposal of Seshia for the definition of MO. Comparison of children affected by MA or MO with those affected by TTH (definition according to the Seshia criteria), for characteristics which are not included in the criteria.

Slide 4 :

Patients 320 children (144 male), age 3-14 y. (mean age 9.9 y.), with recurrent or chronic headaches. First seen between 1996 and 1999. Living in Milan or surrounding regions. Duration of their history: at least 4 months. At least 5 attacks during the previous year ( 2 attacks in case of migraine with aura). Excluded secondary headaches.

Slide 5 :

Procedure Questionnaire on: characteristics of headaches, associated symptoms, precipitating factors. Neurological and general examinations. Further examinations when clinically necessary. Statistical evaluation of each item performed. For some variables, chi-square calculated.

Slide 6 :

Results: Percentages of children with various characteristics (the most important) in some attacks in all attacks Unilateral pain 6.2 15.6 Pulsating pain 12.8 28.4 Nausea, vomiting 6.2 4.1 Abdominal pain 17.5 4.7 Dizziness 21.2 12.8 Photophobia 16.8 26.8 Phonophobia 18.4 33.4 Confusion 7.5 5.0 Visual aura 11.6 1.9 Other types of aura 1.8 1.6 Moderate or severe intensity 11.0 85.6 Lie down in the dark or with closed eyes 23.7 20.0 Mean duration of attacks <1 h 12.2 Mean duration of attacks 1-2 h 32.5

Slide 7 :

Diagnostic criteria for MO according to IHS and to Seshia IHS At least 5 attacks Duration at least 2 hours Two of the following: Unilateral location Pulsating quality Moderate or severe intensity Aggravation by walking up stairs During attacks at least one of: Nausea or vomiting Both photophobia and phonophobia (has to lie in dark quiet room) Seshia At least 5 attacks Duration at least 1 hour Two of the following: Unilateral or bilateral location Pulsating quality Moderate or severe intensity Aggravation by walking up stairs, running,any sports Migraine in parents or siblings During attacks at least one of: Severe nausea or vomiting or moderate to severe abdominal pain. Severe photophobia or phonophobia

Slide 8 :

Results: Percentages of children affected by various headache forms according to IHS and to Seshia criteria

Slide 9 :

Results As seen in the previous slide, using the Seshia criteria instead of the IHS criteria a higher number of children were included in the MO form. Bilateral pain and family history of migraine were the most important factors which allowed a shift of children into this form. However, with the Seshia classification there was no reduction in the number of un-classifiable children. The reason of that , was for some children a short duration of attacks. The majority of unclassifiable children were 6 years old or less. With both classifications the number of children with two forms (MA or MO and TTH) is relatively high.

Slide 10 :

Results: Comparison of children with MA, MO and TTH according to Seshia criteria for some characteristics not included in the classification criteria

Slide 11 :

Results. For the factors mentioned in the previous slide a significant difference was found. A higher number of precipitating factors and a greater severity of attack was associated with MO when compared to TTH. On the contrary, no difference was found between children with MO and those with TTH for the following variables: occurrence of attacks after school, reduction of attacks during school holidays, full-time schooling, after-school activities on school days, disordered daily life.

Slide 12 :

Most important references Headache Classification Committee of the International Headache Society. (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial. Cephalalgia 8, Suppl. 7 Seshia SS, Wolstein JR, Adams C, Booth FA, Reggin JD. (1994) International Headache Society criteria and childhood headache. Dev Med Child Neurol 36: 419-428. See also the second edition of the IHS Classification. (2004). Cephalalgia 24, Suppl. 1 See also the related article: Rossi LN et al. Analysis of the International Classification of headache disorders (ICHD-II) for diagnosis of migraine and tension-type headache in children. (2008) Dev Med Child Neurol 50: 305-310.

	livia.rossi@unimi.it 1 Years ago. Category: Obstetrics and Gynecology

Tags:	Obstetrics and Gynecology

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