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

mystery of yawning 

 

 

 

 

mise à jour du
20 juillet 2019
Pediatric Neurology
2019;97:26-29
Premonitory Symptoms in Episodic
and Chronic Migraine
from a Pediatric Headache Clinic
 
Howard Jacobs, Ann Pakalnis
Section of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio

Chat-logomini

 
Abstract
Objective: We evaluated the frequency of six commonly reported adult migraine premonitory symptoms in children and adolescents with episodic and chronic migraine and elicited psychological or behavioral comorbidities that may be associated with these symptoms.
 
Background: Premonitory symptoms are commonly reported in the adult migraine population; however, little information is available for the pediatric population.
 
Methods: Data were collected on new patients being evaluated in our multidisciplinary pediatric headache clinic over a six-month time interval. The data collected from patients diagnosed with migraine were then reviewed for the following premonitory symptoms: yawning, neck stiffness, fatigue, increased urination, mood changes, and food cravings. History was obtained regarding the frequency of headaches and other associated behavioral or psychological problems.
Results: A total of 176 patients were enrolled over a six-month interval, ranging in age from four to 18 years (mean age 12 years); 64% were female, and 42% (74 of 176) of the subjects had at least one premonitory symptom. Patients with migraine with aura were noted to have a significantly higher association with premonitory symptoms (59%, 30 of 51) (P < 0.05). Anxiety disorder was also significantly associated with premonitory symptoms (55%, 11 of 20) (P < 0.05). Fatigue and mood changes were the most commonly reported premonitory symptoms.
 
Conclusions: Premonitory symptoms occurred frequently in our population of pediatric patients with migraine. Fatigue and mood changes were the most frequent symptoms. There were no significant differences in premonitory symptoms by gender or age group (less than 12 years versus greater than 12 years). Anxiety and migraine with aura were correlated with an increased likelihood of premonitory symptoms.
Les auteurs ont évalué la fréquence de six symptômes prémonitoires de migraine chez l'adulte, fréquemment rapportés, chez les enfants et les adolescents atteints de migraine épisodique et chronique, ainsi que des comorbidités psychologiques ou comportementales pouvant être associées à ces symptômes. Les symptômes prémonitoires sont fréquemment rapportés dans la population migraine adulte ; cependant, peu d'informations sont disponibles pour la population pédiatrique.
 
Les données ont été recueillies chez les nouveaux patients en cours d'évaluation dans leur clinique multidisciplinaire de traitement des céphalées pédiatriques sur une période de six mois. Les données recueillies chez les patients diagnostiqués comme souffrant de migraine ont ensuite été sélectionnés pour rechercher les symptômes prémonitoires suivants : bâillement, raideur de la nuque, fatigue, augmentation de la fréquence des mictions, changements d'humeur et fringales. Des antécédents ont été recherchés concernant la fréquence des maux de tête et autres problèmes comportementaux ou psychologiques associés.
 
Au total, 176 patients ont été inscrits sur un intervalle de six mois, âgés de 4 à 18 ans (âge moyen : 12 ans); 64% étaient des femmes et 42% (74 sur 176) des sujets présentaient au moins un symptôme prémonitoire. Les patients migraineux avec aura présentaient une association significativement plus élevée de symptômes prémonitoires (59%, 30 sur 51) (p <0,05). Les troubles anxieux étaient également associés de manière significative aux symptômes prémonitoires (55%, 11 sur 20) (p <0,05). La fatigue et les changements d'humeur étaient les symptômes prémonitoires les plus souvent signalés.
 
Les symptômes prémonitoires sont fréquents dans notre population de patients migraineux pédiatriques. La fatigue et les changements d'humeur sont les symptômes les plus fréquents. Il n'y a pas de différence significative pour les symptômes prémonitoires selon le sexe et le groupe d'âge (moins de 12 ans par rapport à plus de 12 ans). L'anxiété et la migraine avec aura sont corrélées à une probabilité accrue de symptômes prémonitoires.
Introduction
Migraine is a common neurological condition in the pediatric population. Prevalence rates of about 10% are generally seen in school-aged children with increasing prevalence in the adolescent population. Migraine attacks can frequently cause absences from school, and family stressors can become magnified when caring for an ill child. Compared with children with tension-type headaches, children with migraine often have more severe, disabling headaches. In addition, about 25% patients with migraine have an aura preceding their headaches manifested by transient symptoms, often a visual or sensory disturbance, which may also contribute to the overall disability of these headaches.
In the adult migraine population, premonitory symptoms (PSs) have been self-reported by most patients before their migraine headaches. These generally precede the migraine by two to 48 hours. These symptoms may be varied in their presentation, both subjective and objective, and can include fatigue, mood changes, and excessive yawning. In two different series of adult patients, the presence of at least one PS ranged from 30% to 80% before the onset of their headaches.
 
PSs in pediatric patients with migraine are less well characterized. Previous studies have been small and retrospective, but PSs were frequently present. Karsan et al, in a retrospective study of 100 patients with predominantly chronic migraine, primarily noted fatigue, mood change, and neck stiffness.7 There were no differences related to age, sex, or headache diagnosis. In another retrospective study evaluating 103 patients, 67% reported at least one PS.8 The most frequently reported symptoms were face changes, fatigue, and irritability. The presence of PSs and the specific symptom reported did not vary with age or migraine subtype.
 
Discussion
Our study revealed that PS was frequent, with nearly half of our subjects experiencing these symptoms before their migraine. Fatigue and mood changes were the most commonly reported symptoms. Previous pediatric studies reported higher percentages of PSs, and this may be attributed to the fact that our study limited the symptoms to the six most commonly reported ones in adult studies.7,8 PS also had a mild but not significant association with increasing frequency of migraine attacks with a majority of patients with chronic migraine reporting PS.
Aura symptomatology was significantly associated with PS in our study. Fifty-nine percent of patients with migraine with aura had PS. In adult studies, a majority of patients with migraine with aura also acknowledged PS, with 79% and 81% noted in prior studies. Variable results were noted with relationship to aura and attack frequency in adult reports.5,6 One pediatric chart review study did not report an increase in PS with aura,7 and another large study did not categorize aura symptomatology in their chart review study of 100 patients.8
PS occurred slightly more often in individuals with more frequent migraine attacks, but the increase failed to reach significance. Patients with medication overuse also had greater prevalence of PS, although the numbers were small and the association was not significant impact of sleep deprivation or missing meals. These symptoms can serve as a reminder to parents or guardians that a migraine attack may be imminent and appropriate abortive treatments should be readily available.
 
Conclusion
PSs were common in our pediatric patients with migraine. Fatigue and mood changes were the most commonly reported symptoms, similar to previous studies. Anxiety and migraine with aura were significantly associated with an increased likelihood of PSs in our group of patients. Elicitation of these symptoms may improve management and lessen the effect of migraine headaches in children and adolescents.