Source:Pediatric Neurology
Author(s): Erica B. Lee, Fredrick S. Edelman, Carl E. Stafstrom
ObjectiveTo determine whether children's headache drawings can distinguish between pseudotumor cerebri and migraine.BackgroundHeadache features associated with pseudotumor cerebri (pseudotumor; idiopathic intracranial hypertension) are nonspecific and difficult to distinguish clinically from migraines. Children's headache drawings have a high predictive value for migraine versus non-migraine headaches. We hypothesized that drawings could help to differentiate pediatric headaches due to pseudotumor cerebri from those associated with migraines.MethodsChildren 6-18 years old attending university hospital pediatric neurology clinics were asked to draw a picture of how their headache feels. From our database of children's headache drawings, pictures by children with clinically diagnosed pseudotumor were compared with migraine drawings.ResultsHeadache drawings of 21 children (16 females) with pseudotumor were compared with those of 518 children with migraine. Pseudotumor drawings depicted a variety of symptoms including pounding pain (n=11), pressure-like pain (3), photophobia (3), dizziness (1), recumbency (1). Severe pain indicators included hammers, bombs, anvil, and vise grip. Positive visual phenomena included scintillations, scotomata, or blurring (8). Negative visual phenomena included field defects (2). Pseudotumor drawings were similar to migraine drawings except that 6 of the 21 (28.6%) pseudotumor drawings depicted diplopia (crossed eyes, double images), whereas only 3 of 518 (0.6%) migraine drawings depicted diplopia (p<0.000001).ConclusionsDiplopia was depicted in a significantly higher percentage of pseudotumor drawings than migraine drawings. In all other respects, headache drawings by children with pseudotumor cerebri were similar to those drawn by children with migraine.
http://ift.tt/2hMm5ln
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου