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目的探索貌似癫的小儿偏头痛诊断及鉴别诊断的思路。方法对7例误诊或疑诊为癫性头痛的患儿,进一步行24h动态脑电图、影像学、经颅超声多普勒(TCD)检查,寻找头痛诊断的客观依据。结果7例患儿做TCD检测全部有异常,5例颅内血管呈不对称性血流速度增快,2例血流速度减慢;24h动态脑电图记录,在头痛发作期以及间歇期,未描记到样放电。结论对于貌似癫的头痛患儿,经综合检查,能够从癫性头痛中鉴别出偏头痛。
Objective To explore the pediatric migraine seemingly epilepsy diagnosis and differential diagnosis of ideas. Methods Seven children with misdiagnosed or suspected epileptic headache were further studied with 24-hour dynamic electroencephalogram, imaging and transcranial Doppler ultrasound (TCD) to find out the objective evidence of headache diagnosis. Results All 7 cases had abnormal TCD, 5 cases of intracranial vascular asymmetry, the blood flow rate was increased, 2 cases of blood flow slowed down; 24 hours EEG recorded in the headache and intermittent episodes, Did not trace to the kind of discharge. Conclusions For children with seemingly epileptic headaches, migraine headaches can be identified from epileptic headaches by comprehensive examination.