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[Migraine in a pediatric emergency service]
J Sánchez Echaniz1, M Santiago Burruchaga, J Benito Fernández
1Departamento de Pediatría, Hospital de Cruces, Baracaldo, Vizcaya.
Anales Espanoles De Pediatria
|April 1, 1991
Summary
In a pediatric emergency room study, 8 of 105 patients with migraine-like symptoms received different diagnoses, including serious neurological conditions. Early diagnosis is crucial for effective pediatric migraine management.
Area of Science:
- Neurology
- Pediatrics
- Emergency Medicine
Context:
- Pediatric Emergency Room (PER) encounters for migraine and migraine-like attacks.
- One-year study period involving 105 pediatric patients.
- Evaluation of clinical features and diagnostic procedures for acute headache presentations.
Purpose:
- To analyze the clinical characteristics of pediatric patients presenting with migraine or migraine-like attacks in the ER.
- To identify cases where initial migraine diagnosis was revised due to other underlying conditions.
- To assess the utilization of neurodiagnostic procedures and hospitalization rates.
Summary:
- Out of 105 pediatric patients presenting with migraine-like symptoms, 8 (7.6%) were diagnosed with alternative serious conditions such as cerebral tumors, subarachnoid hemorrhage, epilepsy, and meningitis.
- Neurologic deficits and aura symptoms were more common in patients with non-migraine diagnoses.
- Neurodiagnostic tests (EEG, lumbar puncture, CT scan) were performed in 20% of cases, with 30% having prior ER visits for similar symptoms. Only 5% required hospital admission.
Impact:
- Highlights the importance of thorough diagnostic evaluation in pediatric emergency settings for acute headache presentations.
- Underscores the potential for serious underlying neurological conditions to mimic migraine in children.
- Informs clinical practice regarding the differential diagnosis and management of pediatric headaches in emergency care.