A sample of 171 children and adolescents aged 3-17 years requiring venepuncture for blood sampling were asked to report on their pain and anxiety and were observed immediately before and during blood drawing. Depending on the measures used, 36-64% of children from 3 to 6 years old experienced moderate to severe distress from blood drawing. Multiple regression analysis revealed that age and the parents' prediction of how upset the child would feel before the blood test was a significant predictor of the observed distress and the self-report of pain. Experience with previous needle procedures did not add significantly to the prediction of distress. Identification of children at high risk to respond poorly to painful medical procedures is discussed.
Previous studies have evaluated the clinical features and characteristics of migraine in selected children attending hospital clinics. There have, however, been no community studies on the prevalence and characteristics of migraine in children aged 3-11 years in British general practice. In this study, a total of 1,083 children (from 1,104 registered with a general practice) and their parents were interviewed. Possible migraine sufferers took part in an extended interview that assessed various characteristics of the patients and their attacks. The survey showed that migraine attacks started in infancy, and migrainous children were more likely to have mothers with migraine. Some clinical features were found to be age-dependent. Compared with similar hospital surveys there was a lower frequency of attacks recorded but the prevalence of aura was similar to that found in previous studies.
SUMMARY In a survey conducted by a UK urban general practice, 98·1 per cent (1083) of the children registered aged three to 11 years took part in an interview. Possible migraine subjects took part in an extended interview, the results of which were recorded using three different sets of diagnostic criteria: Vahlquist, Ad Hoc and International Headache Society. The prevalence of migraine ranged from 3·7 to 4·9 per cent, depending on the criteria used. The prevalence of migraine with aura (1·5 per cent) was similar by all criteria, whereas that for migraine without aura ranged from 2·2 to 3·4 per cent. The prevalence of migraine increased with age. The IHS criteria appeared less sensitive than the Ad Hoc for migraine without aura. Operational criteria using three attacks lasting longer than one hour may be more specific for the diagnosis of migraine in young children. RÉSUMÉ Epidémiologie des maux de tête et migraine de l'enfance dans la pratique urbaine génerale, utilisant les critères Ad Hoc, Vahlquist et IHS Dans une étude de pratique générale au Royaume Uni, 98·1 pour cent (1083) des enfants recencés de trois à 11 ans prirent part aux entretiens. Les sujets exposés a la migraine bénéficièrent d'entretiens plus apprafondis dont les résultats furent enregistrés selon trois ensembles de critères diagnostiques: Valhlquist, Ad Hoc et l'International Society Headache. La prévalence de la migraine était comprise entré 3·7 et 4·9 pour cent. Selon les critères utilisés la prévalence de la migraine avec aura (1·5 pour cent) était identique pour tous les critères tandis que la prévalence de la migraine sans aura allait de 2·2 a 3·4 pour cent. La prévalence de la migraine augmentait avec l'âge. Les critères IHS sont apparus moins sensibles que les critères Ad Hoc pour la migraine sans aura. Les critères operationnels partant de trois attaques durant plus d'une heure peuvent être plus specifiques pour le diagnostic de migraine chez le jeune enfant. ZUSAMMENFASSUNG Epidemiologie des Kopfschmerzes und der kindlichen Migräne in einer städtischen Allgemeinpraxis unter Verwendung der Ad Hoc, Vahlquist Und IHS Kriterien In einer Übersicht einer UK Allgemeinpraxis nahmen 98·1 Prozent (1083) der registrierten Patienten an einem Interview teil. Potentielle Migränepatienten wurden eingehender befragt und die Ergebnisse wurden nach drei verschiedenen diagnostischen Kriterien aufgezeichnet: Valquist, Ad Hoc und International, Headache Society. Die Häufigkeit der Migräne schwankte zwischen 3·7 und 4·9 Prozent, was von den benutzten Kriterien abhing. Die Häufigkeit der Migräne mit Aura (·5 Prozent) war bei alien Kriterien ähnlich, während die der Migräne ohne Aura zwischen 2·2 und 3·4 schwankte. Die Migränehäufigkeit nahm mit dem Alter zu. Die IHS Kriterien schienen für die Migräne ohne Aura weniger empfindlich zu sein als die von Ad Hoc. Bei jungen Kindern sind drei über eine Stunde dauernde Anfälle spezifischer für die Diagnose der Migräne. RESUMEN Epidemiologia de la cefalalgia y de la migraña infantil en la practica general urbana ut...
The lifetime prevalence of headache and migraine was assessed in an unselected sample of atopic (asthma, eczema or rhinitis) children in a general practice population of known socio-economic and age/sex composition. Maternal migraine was also recorded. The prevalence of both headache and migraine was significantly and proportionally higher in children with atopic disorders compared to those without. Childhood migraine was associated with atopy and the association was strongest with rhinitis. Rhinitis in children was associated with maternal migraine. A history of atopy (especially rhinitis) supports the diagnosis of migraine in young children with paroxysmal headaches.
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