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 CONCEPT
The headache in his set is the second chronic process in the infancy, after the obesity.
The migraine, nevertheless, must not be considered any more than a symptom: The causes of infantile migraine are multiple, from the depletion of the incidental muscles of the eye due to a forced accommodation (miopías, etc) up to the cerebral tumors. But they are especially frequent and they deserve study separate the migrañosos syndromes or migraines of the child and of the adolescent.
The migraine or migraine, it is a periodic chronic migraine, which it studies in sprouts with periods of absolute normality. There always collaborates a group of symptoms, of which the most typical are:
- Unilateral location.
- Pulsatile presentation.
- It improves with the sleep.
- Visual, sensory aura or previous motorboat.
- Abdominal pain, morning sickness, vomiting.
- Familiar history (89 %).
- Duration from 2 until 72 hours.
The factors precipitantes of the migraine in the infancy are:
- Psychological (Often students)
- Nutritive 10-40 % (*)
- Intolerance to the lactose 40 %
- Hypoglycemia 25 %
- Physical exercise 24 %
- Sinusitis and infections ORL 4 %
- Hormonal 2 %
(*) The implied food is usually the chocolate, tea, coffee, additives, and the proper cow milk.
CLASSIFICATION
1. Syndromes migrañosos frequent
- Classic migraine
- Common migraine
- Migraine in accumulations ("cluster headache")
2. Periodic syndrome of the infancy (equivalents migrañosos)
- Cyclical vomiting
- Abdominal migraine
- Vertiginous crises
- Migraines and periodic fever
- Pains paroxísticos of the extremities.
3. Syndromes migrañosos complex or complicated
- Hemisíndrome migrañoso
- Migraine vertebrobasilar
- Migraines confusionales
- Migraine oftalmopléjica
- Syndrome migrañoso complex with pleocitosis of LCR.
4. Complications migrañosas
- Cerebral infarction
- Status migrañoso
SYMPTOMS
- The classic migraine (migraine with aura) studies with pulsatile and monoside headache, with vomiting. He accompanies himself of "aura" or symptoms that precede the migraine: focal, sensitive, visual, sensory malfunctions or motorboats.
- The common migraine is equal to the previous one but without auras.
- The migraine in bunches appears with periorbitario pain, injection conjuntival, lacrimeo, and nasal obstruction. It usually lasts from 10 until 60 minutes, more in the night, without accompanying itself of morning sickness.
- The abdominal migraine consists of painful abdominal paroxysms appellants who accompany themselves of morning sickness and vomiting; an intolerance has been demonstrated to the lactose in 40 % of the cases.
- The syndromes migrañosos complex present themselves as focal or multifocal intense auras, and for it the study is usually precise to discard organic pathologies (tumors, etc).
- The migraine oftalmopléjica is very rare, it is accompanied of palsy of the muscles that move the eyeball.
- The states migrañosos are of more than 72 hours of duration, and they usually raise problems of treatment.
TREATMENT
- I rest in bed
- Analgesics: paracetamol or aspirin associated with caffeine or codeine.
- Antiemetic (to avoid the vomiting): domperidona.
- Oxygen in mask to 100 % 30 to 45 minutes (in hospital).
The ergotamina is slightly useful in the infancy; it can be used in the aura.
- Preservative:
- Ciproheptadina. It is an antihistamine medicine, antiserotonínico and anticolinérgico. It is of election in the infancy.
- Dimetotiazina
- Propanolol, is a betabloqueante.
- Amitriptilina, is an antidepressant tricíclico.
- Metisergida.
- Pizotifen (antihistamine similar to the ciproheptadina).
- Flunarizina (antihistamine similar to the ciproheptadina).
- Indometacina (anti-inflammatory and analgesic).
- The steroids can be used in the states migrañosos (migraines of more than 3 days).
In any case, before the appearance of a headache appellant or persistent in the infancy, it agrees to consult with the pediatrician, who will determine what other subsequent studies are necessary, and if it is necessary or not that the child is valued by a neuropediatra.
WHAT DOCTOR CAN TREAT ME?
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CONCEPT 
