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Cefaleias em idade pediátrica : estudo numa população em hospital terciário universitário
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Associadas a uma considerável morbilidade, as cefaleias são uma perturbação muito prevalente na população pediátrica, podendo raramente ser forma de apresentação de patologias muito graves. Propomo-nos a caracterizar clinica e demograficamente os indivíduos em seguimento na consulta de Neuropediatria do Hospital de Santa Maria (HSM), avaliando os critérios diagnósticos, investigação complementar e resposta à terapêutica. Confrontando e comparando estes resultados com os critérios diagnósticos utilizados em adultos e outros estudos similares, espera-se discriminar as peculiaridades desta população. O trabalho decorreu de forma prospectiva, através dum inquérito preenchido pelos Neuropediatras assistentes aquando a observação do doente em seguimento por cefaleias entre 1 Junho de 2014 e 31 Maio de 2015. Incluíram-se 110 doentes. Destes, 77,3% tiveram diagnóstico de enxaqueca, 12,7% de cefaleia de tensão e 10% de cefaleia com características mistas. No caso das enxaquecas, a dor caracterizava-se por ser bilateral (72,9%), pulsátil (47,1%) ou tipo aperto (24,7%), de elevada intensidade (51,8%) e associada a sintomas como náusea (42,4%), vómito (38,8%) e fotofobia (22,4%), com uma duração inferior a quatro horas (69,5%). Independentemente do diagnóstico, a história familiar materna foi um factor presente. Os factores desencadeantes como o stress (76,5%) e a privação de sono (29,4%) podem ser modulados preventivamente.
Considering its high morbidity, headaches are seen as a prevalent disorder in the paediatric population and they can be the first manifestation of more serious diseases. We propose to characterize clinically and demographically the individuals followed in the Neuropaediatric service of Hospital de Santa Maria (HSM), through the analysis of the diagnostic criteria, complementary investigation and its therapeutic response. We also aim to confront and compare our results with the diagnostic criteria used for adults and with similar studies, so we can find some particularities of this population. Our work was a prospective study through a questionnaire filled by the Assistant Neuropaediatricians as they observed the patient followed by a diagnostic of headache, in the period between 1st June 2014 and 31st May 2015. 110 patients were included. Of those, 77,3% had migraine, 12,7% tension-type headache and 10% headache with multiple characteristics. In those with migraine, the pain was bilateral (72,9%), pulsatile (47,1%) or squeezing (24,7%), of high intensity (51,8%) and associated with symptoms like nausea (42,4%), vomiting (38,8%) and photophobia (22,4%) and had a medium duration of less than four hours (69,5%). We can try to prevent the trigger factors such as stress (76,5%) and sleeping deprivation (29,4%). Despite the diagnosis, maternal family history was a present factor. The trigger factors like stress (76,5%) and sleep deprivation (29,4%) can be used as a basis for a prevention strategy.
Considering its high morbidity, headaches are seen as a prevalent disorder in the paediatric population and they can be the first manifestation of more serious diseases. We propose to characterize clinically and demographically the individuals followed in the Neuropaediatric service of Hospital de Santa Maria (HSM), through the analysis of the diagnostic criteria, complementary investigation and its therapeutic response. We also aim to confront and compare our results with the diagnostic criteria used for adults and with similar studies, so we can find some particularities of this population. Our work was a prospective study through a questionnaire filled by the Assistant Neuropaediatricians as they observed the patient followed by a diagnostic of headache, in the period between 1st June 2014 and 31st May 2015. 110 patients were included. Of those, 77,3% had migraine, 12,7% tension-type headache and 10% headache with multiple characteristics. In those with migraine, the pain was bilateral (72,9%), pulsatile (47,1%) or squeezing (24,7%), of high intensity (51,8%) and associated with symptoms like nausea (42,4%), vomiting (38,8%) and photophobia (22,4%) and had a medium duration of less than four hours (69,5%). We can try to prevent the trigger factors such as stress (76,5%) and sleeping deprivation (29,4%). Despite the diagnosis, maternal family history was a present factor. The trigger factors like stress (76,5%) and sleep deprivation (29,4%) can be used as a basis for a prevention strategy.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Cefaleias Enxaqueca Cefaleias tensão Cefaleias mistas População pediátrica Terapêutica