Cefalea en infantes

Descripción general del diagnóstico y tratamiento de la cefalea pediátrica. Parte I: diagnóstico. Overview of diagnosis and management of paediatric headache. Part I: diagnosis. Ozge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl C. Department of Neurology, Mersin University School of Medicine, Mersin, Turkey. J Headache Pain. 2011 Feb;12(1):13-23. Epub 2011 Feb 27. Abstract Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056001/pdf/10194 _2011_Article_297.pdf  Visión actualizada de la cefalea y la migraña pediátrica. Updated overview of pediatric headache and migraine. Jan MM. Department of Pediatrics (Neurology), King AbdulAziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia.mmsjan@yahoo.ca Saudi Med J. 2007 Sep;28(9):1324-9. Abstract Headache is a common complaint, occurring in >90% of school age children. The frequency increases with increasing age and the etiologies range from tension to life-threatening infections and brain tumors. Migraine is the most frequent cause of acute and recurrent headaches in children. The overall prevalence of non-migraine headaches is 10-25%. A thorough history, physical and neurological examination, and appropriate diagnostic testing if indicated will enable the physician to distinguish migraine and tension headaches from those of a secondary etiology. In this review, we present an updated overview of childhood headaches. The recently developed International Classification of Headache Disorders, second edition ICHD-II will be summarized. The Quality Standards Subcommittee of the American Academy of Neurology AAN and the Practice Committee of Child Neurology Society CNS recommendations for neuroimaging of children with recurrent headaches concluded that routine neuroimaging is not indicated if the neurological examination is normal. Neuroimaging should be considered in children with recent onset of severe headache, change in the headache type, associated focal neurological features, or seizures. Trends in the management guidelines will be highlighted. http://www.smj.org.sa/PDFFiles/Sep07/01Updated20070080.pdf

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