Migraine is a group of periodic attacks with a family tendency to develop. It is characterized by episodes of migrainous throbbing headache with nausea and vomiting, and sensitivity to light or sound stimuli. The incidence of typical migraine in childhood is about 2% to 5%. The etiology and pathogenesis of migraine have not yet been elucidated.
How is migraine diagnosed?
(I) Medical history
Detailed medical history and careful physical examination should be conducted.
(II) Clinical manifestations
1.Headache: It starts as pulsating pain in frontal, temporal, supraorbital or retroorbital area on one side, and may extend to half of the head or upper neck. It may or may not be accompanied by aura.
2.Aura symptoms: There are one or more of the following aura before the attack: hemianopia; hemianesthesia or numbness; hemianopia; or aphasia or unclassifiable speech disorder.
3.Concomitant symptoms: between the end of the aura and the beginning of the headache, there are emotional, thinking or speech disorders, somatic symptoms, hemianesthesia, light hemiparesis, weakness, etc. The headache attack is accompanied by nausea, vomiting, pallor, fatigue, photophobia, fear of sound or olfactory allergy. In young children, the only symptoms are crying, vomiting, head patting, hair scratching, pallor and depression. Some children are accompanied by incomplete or complete paralysis of the eye muscles.
4.Migraine equilibrium: that is, there are similar intervals of migraine with symptoms of periodic attacks, such as only aura without headache; benign episodic vertigo in children; abdominal migraine; periodic vomiting, etc.
5.Typing.
(1) Typical migraine
(2) General migraine
(3) Oculomotor paralysis type migraine
(4) Hemiplegic migraine
(5) Basilar artery type migraine
(6) Migraine equilibrium
(C) Auxiliary examination
1. EEG: Paroxysmal, diffuse slow waves may appear, and occasionally spike waves may appear. However, there is no specificity and regularity.
2.Cranial ultrasound Doppler (TCD): cerebral vascular spasm or dilatation can be seen, and the TCD can help in the selection of clinical treatment drugs.
(D) Diagnostic criteria
There is no unanimous unified diagnostic standard, but the diagnosis of migraine should be considered after the follow-up observation of treatment effect, except for the headache caused by other reasons. 1976 Prensky proposed the following diagnostic criteria for reference.
1. Recurrent headache with intermittent periods completely normal, excluding headache caused by other organic diseases;
2. Three of the following six criteria are present.
(1) Headache attacks accompanied by nausea, vomiting and abdominal pain.
(2) Lateral headache.
(3) throbbing or throbbing headache.
(4) Relief after short-term rest or sleep.
(5) Visual, sensory or motor aura.
(6) A positive family history.