ABSTRACT
OBJECTIVE: Migraine is a common condition in the pediatric population and causes a significant impact on the quality of life. Atopic disorders are some of the migraine comorbidities. We hypothesized that allergic rhinitis could aggravate migraine in the pediatric population. METHODS: This cross-sectional study consecutively evaluated 90 pediatric outpatients (46 children 6-12 years of age; 44 adolescents up to 18 years of age) who sought medical assistance because of migraine at a general neurology clinic in Passo Fundo, RS, Brazil. They, and their parents, were given three questionnaires, to evaluate the diagnosis of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis, as well as the disability caused by headache (ISAAC - International Study of Asthma and Allergies in Childhood; CARATkids - Control of Allergic Rhinitis and Asthma Test for Children; PedMIDAS - Pediatric Migraine Disability Assessment). The study was approved by the local ethics committee. RESULTS: According to the ISAAC questionnaire, children with current allergic rhinoconjunctivitis in the last year showed higher scores on the PedMIDAS than those patients without atopy (median and interquartile range 26 [10-58] vs. 5 [1-13], p = 0.008). A significant positive correlation of CARATkids scores with PedMIDAS scores was found (p = 0.007, rho = 0.39). After including other putative predictors of migraine disability (age, body mass index, time since onset of migraine) in a multiple regression analysis, only the scores on the CARATkids remained a significant independent variable correlated with PedMIDAS scores (p = 0.001; R = 0.55; R2 = 0.30). CONCLUSIONS: Current allergic rhinoconjunctivitis is related to enhanced disability caused by headache in childhood migraine.
Subject(s)
Migraine Disorders/etiology , Rhinitis, Allergic/complications , Adolescent , Age Factors , Body Mass Index , Child , Cross-Sectional Studies , Disability Evaluation , Female , Humans , Male , Migraine Disorders/physiopathology , Quality of Life , Rhinitis, Allergic/physiopathology , Risk Factors , Severity of Illness Index , Statistics, Nonparametric , Surveys and Questionnaires , Time FactorsABSTRACT
ABSTRACT Migraine is a common condition in the pediatric population and causes a significant impact on the quality of life. Atopic disorders are some of the migraine comorbidities. Objective We hypothesized that allergic rhinitis could aggravate migraine in the pediatric population. Methods This cross-sectional study consecutively evaluated 90 pediatric outpatients (46 children 6-12 years of age; 44 adolescents up to 18 years of age) who sought medical assistance because of migraine at a general neurology clinic in Passo Fundo, RS, Brazil. They, and their parents, were given three questionnaires, to evaluate the diagnosis of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis, as well as the disability caused by headache (ISAAC - International Study of Asthma and Allergies in Childhood; CARATkids - Control of Allergic Rhinitis and Asthma Test for Children; PedMIDAS - Pediatric Migraine Disability Assessment). The study was approved by the local ethics committee. Results According to the ISAAC questionnaire, children with current allergic rhinoconjunctivitis in the last year showed higher scores on the PedMIDAS than those patients without atopy (median and interquartile range 26 [10-58] vs. 5 [1-13], p = 0.008). A significant positive correlation of CARATkids scores with PedMIDAS scores was found (p = 0.007, rho = 0.39). After including other putative predictors of migraine disability (age, body mass index, time since onset of migraine) in a multiple regression analysis, only the scores on the CARATkids remained a significant independent variable correlated with PedMIDAS scores (p = 0.001; R = 0.55; R2 = 0.30). Conclusions Current allergic rhinoconjunctivitis is related to enhanced disability caused by headache in childhood migraine.
RESUMO A enxaqueca é condição comum na população pediátrica e causa significativo impacto na qualidade de vida. Doenças atópicas estão entre as principais morbidades associadas. Objetivo Teorizamos que a rinite alérgica possa agravar a enxaqueca na população pediátrica. Métodos Este estudo transversal avaliou consecutivamente 90 pacientes pediátricos (46 crianças de 6 a 12 anos; 44 adolescentes até 18 anos) que procuraram assistência por enxaqueca em clínica neurológica de Passo Fundo, RS, Brasil. Eles e seus familiares responderam a três questionários para avaliar o diagnóstico de rinite alérgica, rinoconjuntivite alérgica e rinite alérgica sazonal, assim como a incapacidade causada pela cefaleia (ISAAC - International Study of Asthma and Allergies in Childhood; CARATkids - Control of Allergic Rhinitis and Asthma Test for Children; PedMIDAS - Pediatric Migraine Disability Assessment). A pesquisa foi aprovada por comitê de ética. Resultados Crianças com rinoconjuntivite alérgica atual de acordo com o questionário ISAAC exibiram escores mais altos no PedMIDAS do que aquelas sem atopia (mediana e intervalo interquartil 26 [10-58] vs. 5 [1-13], p=0,008). Correlação significativamente positiva do escore no questionário CARATkids sobre o escore do PedMIDAS foi encontrada (p = 0,007, rho = 0,39). Após inclusão de outros fatores teoricamente envolvidos com a incapacidade secundária à enxaqueca (idade, índice de massa corporal, tempo desde o início das crises de enxaqueca) em modelo de análise de regressão linear múltipla, apenas o escore do CARATkids permaneceu com significância como variável independente relacionada ao escore do PedMIDAS (p = 0,001; R = 0,55; R2 = 0,30). Conclusões Rinoconjuntivite alérgica está relacionada ao aumento da incapacidade pela enxaqueca em crianças.