- 소아, 청소년의 이차두통
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Kon Hee Lee
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Korean J Headache. 2010;11(1):7-12. Published online June 30, 2010
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- Although most of headaches in children and adolescents are primary headaches, it is very important to diagnose the secondary causes of headaches. Secondary headaches are divided into the 8 disorder groups including psychiatric problems in ICHD II(The International Classification of Headache Disorders 2nd edition). Common etiologies for secondary headaches in children are Infections, disorders of the cranium, neck, eyes, ears, nose, sinuses, teeth, or other facial or cranial structures, disorders of homeostasis, substance or withdrawal from substances, psychiatric disorders and head and/neck trauma. The other causes are cranial or cervical vascular disorders and nonvascular intracranial disorders, which are rare but life-threatening. It is necessary for us to recognize how to approach several causes of secondary headaches in children, and strategies for neuroimaging studies for headache children.
- 트립탄 투여 후 발생한 뇌경색이 없는 지속조짐 1예
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Ka Young Choi, Kon Hee Lee
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Korean J Headache. 2009;10(1):96-99. Published online June 30, 2009
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Abstract
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- Persistent aura without infarction (PAWOI) is diagnosed when aura symptoms persist for more than 1 week without radiographic evidence of infarction and unaccounted for another condition at the patient with migraine with aura. We report a case of PAWOI aggravated by triptans. Fifteen years-old girl had severe headaches which started 2 years ago, which was more frequently occurred from 9 month ago. Nausea, vomiting, photophobia and phonophobia were accompanied with her headache. She frequently saw flashing lights just before beginning of headache. On the first visit of our clinic, she was diagnosed with migraine with visual aura and was prescribed with sumatriptan 50mg twice a day for PRN use. Shortly after taking sumatriptan, she experienced sensory changes and weakness of four extremities, which caused paralysis of lower extremities, especially right side. Laboratory findings were normal in CSF study, brain MRI and MRA, SPECT, EMG and NCV. Careful history taking revealed that she had various focal neurologic symptoms such as hypercusia, tinnitus, loss of consciousness, vertigo, diplopia, visual symptoms and weakness. She was diagnosed with basilar-type migraine, sporadic hemiplegic migraine and PAWOI provoked by triptan. After 21 days, she was fully recovered. On discharge she was received topiramate and verapamil for prophylaxis. Two years later, she was admitted for persistent sensory symptoms and losing strength in her right leg after taking naratriptan 2.5 mg twice a day from another clinics. She was discharged after 3 weeks with full recovery. PAWOI is uncommon, but one should be cautious to use triptans for basilar-type migraine or hemiplegic migraine in adolescents.
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KHS
