MIGRAINE IN CHILDREN OF THE CITY OF BARNAUL

Abstract

The article presents a description of a migraine attack, prevalence in the Altai Territory, the main provoking factors and problems of primary diagnosis in pediatrics

Full Text

The article presents and information on clinical features of migraine in children , its prevalence and in the Altai region, and problems ah primary diagnosis of migraine in pediatrics.

Key words: migraine, headache, children, express questionnaire, nausea, vomiting

Key words: migraine, headache, children, express questionnaire, nausea, vomiting

Relevance

Migraine - this Purvey -lingual form head bo whether in combination with neurological, gastrointestinal, and autonomic symptoms : nausea, vomiting, increased sensitivity and intolerance to bright light (photophobia), sound ( phonophobia ), smells ( osmofobiya ) [ 1].

The main provoking factors in the development of migraine attacks are: hunger, stress, lack of sleep, gadgets, certain foods, excessive physical activity, change of weather [ 2-5].

However , migraine remains a difficult to diagnose disease m , due to a variety of different symptoms and the impossibility of their adequate interpretation in children [ 6-7].

The prevalence of migraine in the pediatric population ranges from 3% to 15%, and remains completely unexplored [ 8-10 ].

The aim of the study is to identify the prevalence of migraine in children of the city ​​of Barnaul

Research objectives:

1. To question Barnaul schoolchildren using a headache questionnaire
2. Determine the prevalence of migraines in children with headaches
3. To develop an express questionnaire for the diagnosis of migraine for a pediatrician

Patients and methods:

Conducted a survey on the basis of the Altai State Medical University (ASMU) in the amount of 600 children from 12 to 17 years (14.5 + 2.1 years) , enrolled in Barnaul city schools.  The questionnaire included questions reflecting the presence of headache, its nature and location, intensity, provoking and alleviating factors, frequency of occurrence, accompanying symptoms (nausea, vomiting).  In 167 children (27.8%), headache met the diagnostic criteria for migraine in the International Classification of Headache, 3rd revision ( 2018 ).

Statistical processing of the data was carried out using the SPSS 23.0 program with the determination of the mean values, the reliability of differences using the Pearson coefficient x 2 . The difference was considered significant at p <0.05.

Results:

P The prevalence of migraine was 27.8%, Migraine equally frequent in boys and girls (x 2 = 2 , 046, p > 0 , 05).

In 23% of children are headaches occurred daily in 42% of children - on a weekly basis, from 35% - not more than 1 time a month . Pressing headache prevailed ( 70% of children) , less often throbbing ( 30% ) .

The duration of a pain attack is, according to the literature, from 30 minutes to 72 hours in all children with migraine. In children in our study , seizure duration is observed within 3 hours .

The presence of aura in children with migraine is 15% , and about half of the children have accompanying symptoms : nausea 54% , vomiting 49%. The factors provoking a migraine attack were: physical activity (25%), lack of sleep (42 %). Sleep relief is observed in up to 80% of all children.

Discussion:

The revealed changes in the course of work confirm the data of the world literature, the attacks were marked by intense pain and a number of vegetative manifestations [ 1].

Prevalence of migraine in children in the Altai region (27.8%) prevails on several d world (3% -15%), which indicates failure diagnosis of the disease and is not completely investigated in children [ 8-10].

On the basis of the ASMU, no gender differences in the prevalence of migraine were revealed , although according to the literature, the ratio of female to male persons is 4: 1 [ 11 ].

A distinctive feature of the headache during a migraine attack, the majority of our children is proanketirovannyh its crushing or throbbing in nature (70% of children), which differs from the criteria s international classification of headache, which is the predominant throbbing headache [ 12 ].

Conclusions :

1. The prevalence of migraine among schoolchildren in the city of Barnaul was 27.8%. The diagnosis was confirmed after consultation with a neurologist- cephalgologist .
2. The triggers of migraine were most often: female sex, physical activity, lack of sleep. Concomitant symptoms were nausea and vomiting during the attack ; the aura was found in 15% of children with a migraine attack.
3. Based on the provoking factors and symptoms of migraine, an express questionnaire for the diagnosis of migraine for a pediatrician was developed .

Appendix 1 : Questionnaire for a child with a headache

1. Child's name _____       2. Age _______       3. Gender : m / f       4. Headache :  on one side / on 2 sides       5. How the head hurts :  pulsates / D avit / your version _____________________________       6. Duration of headache (minutes, hours) : ________       7. Frequency of headaches : every day / once a week / once a month / your option _______       8. AUR A is a condition that occurs before a headache attack : flashes of light / zigzags in front of the eyes / strange sounds / different smells / Your option __________ 9. Symptoms that are accompanied by a headache :     and. nausea b . vomiting in . photophobia (fear of light) d. hyperacusis (intolerance to loud sound) dizziness e. hyperosmia (hypersensitivity to different odors) Relief factors after which the headache goes away : and. sleep b . strong tea, coffee in. drug (name) _______________ Provoking factors that cause headaches and. exercise stress b . stress in. lack of sleep (less than 8 hours) d. sun (direct sunlight) e. food: bananas / cheese / nuts / smoked meats / chocolate / your option _______ Note: highlighting each item - 1 point. 7-9 b. - a  possible diagnosis of migraine 9-13 b. - the diagnosis of migraine is reliable less than 7 b. - another genesis of headache is likely

Literature             

1. Brna PM , Dooley JM . Headaches in pediatric population . SeminPediatr Neurol . 2006; 13: 222-230

2. Ford S , Finkel AG, Isaacs KL. Migraine in patients with inflam-matory bowel disorders. J Clin Gastroenterol . 2009; 43: 499.

3. Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A., Guandalini S., Hoffenberg EJ, Horvath K., Murray JA, Pivor M., et al. Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J. Pediatr . Gastroenterol. Nutr . 2005 ; 40: 1-19. doi : 10.1097 / 00005176-200501000-00001.

4. Gabrielli M, Cremonini F, Fiore G, et al. Association betweenmigraine and Celiac disease: results from a preliminary case-control and therapeutic study . Am J Gastroenterol . 2003 ; 98: 625-629.

5. Alehan F, Ozcay F, Erol I, et al. Increased risk for celiac diseasein pediatric patients with migraine.Cephalalgia . 2008 ; 28: 945-949.

6. Borgna-Pignatti C, Fiumana E, Milani M, et al. Celiac disease inchildren with migraine.Pediatrics . 2004 ; 114: 1371 .

7. Inaloo S, Dehghani SM, Farzadi F, Haghighat M, Imanieh MH. Acomparative study of celiac disease in children with migraineheadache and a normal control group. Turk J Gastroenterol. 2011 ; 2: 32-35.

8. Herrero R, Martinez A, Martinez-Bermejo A. The prevalence of headache in patients with celiac disease. Rev Neurol. 2001 ; 32: 301-309.

9. Bigal ME, Arruda MA. Migraine in the pediatric population-evolving con- cepts . Headache . 2010; 50 (7): 1130-1143.

10. Kroums L.M., Parfenov A.I., Sabelnikova E.A., Gudkova R.B., Vorobieva N.N. Treatment and prevention of gluten-sensitive celiac disease . Experimental and clinical gastroenterology . 2011; 2: 86-92.

11. Lee LH, Olness KN Clinical and demographic characteristics of migraine in urban children // Headache. 1997. Vol. 37. P. 269-276.
12. Lipton RB, Manack A., Ricci JA et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C- dAS ) // Headache. 2011. Vol. 51. P. 693–706.