Télécharger textes du site

 

 
avec l'aide de
FreeFind

 
Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
http://www.baillement.com
resolutionmini

mise à jour du
1 janvier 2010
Cephalalgia
2009;29:1197-1201
The prevalence of premonitory symptoms in paediatric migraine
a questionnaire study in 103 children and adolescents
 
Cuvellier J-C, Mars A, Vallée L.
 
Migraine and yawning

Chat-logomini

The prevalence and characterization of premonitory symptoms have not been rigorously studied in children and adolescents.
 
Using a questionnaire, Cuvellier et al. retrospectively studied the prevalence of 15 predefined premonitory symptoms in a clinic-based population.
 
In 103 children and adolescents fulfilling the International Classification of Headache Disorders, 2nd edn criteria for paediatric migraine, at least one premonitory symptom was reported by 69 (67%). The most frequently reported premonitory symptoms were face changes, fatigue and irritability.
 
The mean number of premonitory symptoms reported per subject was 1.8 (median 2.2). Age, migraine subtype (with or without aura) and mean attack frequency per month had no effect on the mean number of premonitory symptoms reported per subject.
 
In conclusion, premonitory symptoms are frequently reported by children and adolescents with migraine. Face changes seem to be a premonitory symptom peculiar to paediatric migraine.
 
Migraine affects 4&endash;10% of school-aged children. It is characterized by periodic, paroxysmal episodes of headache accompanied by nausea, vomiting, abdominal pain and intense desire to sleep. On occasion, dramatic signs such as hemiparesis, acute confusional states, ophthalmoparesis or vertigo may precede or accompany migraine headaches.
 
Migraine is characterized by a great variability of phenotypical expressions and it has long been recognized that migraine headaches are frequently associated with a constellation of other non-headache symptoms.
 
The characterization of premonitory symptoms has been poorly studied in children and adolescents.
 
migraine
Discussion (passage)
 
The proportion of paediatric migraine patients reporting premonitory symptoms was high: 67% of patients reported at least one symptom.
 
This high prevalence rate is comparable to two previous retrospective clinic-based adult studies, where the rates were 79 and 86.9%, but in contrast to two other studies, where rates were about 33%.
 
On the other hand, some premonitory symptoms presented by the child were exclusively identifiable by an external observer (such as face changes). Premonitory symptoms were consistently associated with the migraine attack in 64% of patients, a finding that seems higher than what has been reported in adults.
 
The most frequently reported premonitory symptoms were face changes (44%), fatigue (42%) and irritability (24%). Face changes (pallor, shadows under the eyes) seem to be peculiar to children and adolescents, as they have rarely been reported in adult studies.
 
On the other hand, fatigue and irritability have frequently been reported in adult studies, with rates of 72%, 46.5% and 25.6% for fatigue, and 23.4% for irritability. By contrast, some premonitory symptoms that were reported in adults, such as mood and behaviour changes, stiff neck, phonophobia, gastrointestinal symptoms and yawning, were rarely reported in our paediatric subjects.
 
Premonitory symptoms may give insight into the pathophysiology of migraine as an episodic dysfunction of trigeminovascular regulation, probably mediated at the level of the brainstem . Prodromal symptoms, such as yawning, mood changes, irritability, hyperactivity and sleep disturbances, reflect dopaminergic hypersensitivity, and some of them are mediated by nitric oxide pathways.
 
Other symptoms point to a hypothalamic dysfunction. It has been shown that alterations in dopaminergic neurotransmission can modulate clinical susceptibility to migraine and dopamine, at least in a subgroup of migraine patients, and can play an important role in activating the biochemical cascade leading to the premonitory symptoms, and ultimately to the migraine attack.
 
Some authors (15) have postulated that many premonitorysymptoms might reflect the same biological mechanism underlying the headache phase (disinhibition of brainstem nuclei regulating the amount of pain and other sensory inputs, and their associated motor and autonomic activities). In this setting, the fullblown migraine headache would finally develop when a critical physiological threshold is reached.