兒童及青少年時期的頭痛

頭痛在兒童及青少年是一種常見的疾病，它可以是原發性頭痛，例如偏頭痛、壓力性頭痛或是叢集性頭痛；也可以是次發性頭痛，例如全身性或中樞神經疾病所引起的，然而在兒童及青少年時期的頭痛很少是肇因於嚴重的中樞神經疾病。在臨床上，我們可以依據頭痛發作的時序與嚴重度將其分為五大類的頭痛疾病，急性頭痛通常與急性上呼吸道感染或是其他會導致發燒的疾病有關；急性反覆性頭痛在兒童及青少年時期最常見的就是偏頭痛與叢集性頭痛；慢性非進行性頭痛，例如壓力性頭痛，比較常見於較大的兒童或是青少年，尤其是在承受身心方面壓力的時候；慢性進行性頭痛通常要小心排除腦部器質性的病變，例如腦瘤或是水腦症。小兒科醫師在處理患有頭痛的病患時，尤其是年紀小的小朋友，一定要仔細地釐清頭痛發生的模式及可能的病因。本篇文章將介紹三種在兒童及青少年時期較常見的原發性頭痛，包括偏頭痛、壓力性頭痛與叢集性頭痛。在頭痛的治療方面，除了藥物之外，鼓勵病童改變生活型態及加強父母的衛生教育，對於控制頭痛也有很大的助益。

關鍵字

兒童；青少年；頭痛；偏頭痛；壓力性頭痛；叢集性頭痛

並列摘要

Headache is a common problem in children and adolescents. It may be a primary disorder, such as migraine, tension headache, or cluster headache, or a disorder secondary to a systemic illness or a central nervous system disorder. However, serious neurological disorders are uncommon causes of headache in children and adolescents. In clinical practice, we can classify headache disorders into five major types according to the temporal pattern and the severity of the headache. Acute headache is usually related to upper respiratory tract infection or other febrile illness. Acute recurrent headache commonly seen in children and adolescents includes migraine and cluster headache. Chronic non-progressive headache, such as tension headache, is more common in older children and adolescents bothered by physical or emotional stress. Chronic progressive headache usually implies central nervous system disorder, such as brain tumor or hydrocephalus. Pediatrician should clarify the pattern and etiology of headache carefully, especially managing young children with headache. This article reviews three common primary headache disorders in children and adolescents, includes migraine, tension headache and cluster headache. Besides pharmacological treatment, life style modification and education for parents are also benefit for therapy of headache disorders.

並列關鍵字

children ； adolescent ； headache ； migraine ； tension headache ； cluster headache

國際替代計量

兒童及青少年時期的頭痛

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