由于定义是基于症状,在 2 岁以内的儿童中,很少诊断偏头痛,但在更大年龄的儿童中,越来越多地诊断该病。[1]Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629-808.https://www.ichd-3.org/http://www.ncbi.nlm.nih.gov/pubmed/23771276?tool=bestpractice.com[3]Goadsby PJ. To scan or not to scan in headache. BMJ. 2004;329:469-470.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15331454http://www.ncbi.nlm.nih.gov/pubmed/15331454?tool=bestpractice.com[4]Migraine. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of pediatrics. 16th ed. Philadelphia, PA: Saunders; 2000:1832-1834. 男孩和女孩的平均发病年龄分别为 7.2 岁和 10.9 岁,20% 的儿童在 5 岁以前初次发病。[5]Stewart WF, Linet MS, Celentano DD, et al. Age- and sex-specific incidence rates of migraine with and without visual aura. Am J Epidemiol. 1991 Nov 15;134(10):1111-20.http://www.ncbi.nlm.nih.gov/pubmed/1746521?tool=bestpractice.com[6]Stewart WF, Lipton RB, Celentano DD, et al. Prevalence of migraine headache in the United States. JAMA. 1992;267:64-69.http://www.ncbi.nlm.nih.gov/pubmed/1727198?tool=bestpractice.com 在青春期前男女发病比例相等,但之后以女性发病为主 (3:1)。[7]Mortimer MJ, Kay J, Gawkrodger DJ, et al. The prevalence of headache and migraine in atopic children: an epidemiological study in general practice. Headache. 1993;33:427-431.http://www.ncbi.nlm.nih.gov/pubmed/8262782?tool=bestpractice.com[8]Lipton RB, Silberstein SD, Stewart WF. An update on the epidemiology of migraine. Headache. 1994;34:319-328.http://www.ncbi.nlm.nih.gov/pubmed/7928310?tool=bestpractice.com 基于症状的定义妨碍了对极年幼儿童的诊断。[5]Stewart WF, Linet MS, Celentano DD, et al. Age- and sex-specific incidence rates of migraine with and without visual aura. Am J Epidemiol. 1991 Nov 15;134(10):1111-20.http://www.ncbi.nlm.nih.gov/pubmed/1746521?tool=bestpractice.com[6]Stewart WF, Lipton RB, Celentano DD, et al. Prevalence of migraine headache in the United States. JAMA. 1992;267:64-69.http://www.ncbi.nlm.nih.gov/pubmed/1727198?tool=bestpractice.com 有证据表明,过去 30 年以来发病率在不断升高,[9]Bille B. Migraine in schoolchildren. Acta Paediatr Suppl. 1962;136:1-151.http://www.ncbi.nlm.nih.gov/pubmed/13869189?tool=bestpractice.com 据统计,5-15 岁儿童中有 1/9 的儿童受累。目前无令人信服的证据表明患病率随社会阶层不同而有变化。[10]Deubner DC. An epidemiologic study of migraine and headache in 10-20 year olds. Headache. 1977;17:173-180.http://www.ncbi.nlm.nih.gov/pubmed/893091?tool=bestpractice.com 据估计,目前英国每 1000 名学龄儿童中约有 50 名受累,欧盟国家约有 780 万名儿童受累。[11]Evers S. Drug treatment of migraine in children. A comparative review. Paediatr Drugs 1999;1:7-18.http://www.ncbi.nlm.nih.gov/pubmed/10937475?tool=bestpractice.com 在美国,患病率约为 4%-7%。[12]Linet MS, Stewart WF, Celentano DD, et al. An epidemiologic study of headache among adolescents and young adults. JAMA. 1989;261:2211-2216.http://www.ncbi.nlm.nih.gov/pubmed/2926969?tool=bestpractice.com 在发达国家进行的研究表明,在因头痛就诊的儿童中,偏头痛是执业医师给出的最常见诊断。[13]Barnes N, Millman G, James E. Migraine headache in children. Clin Evid. 2006;15:469-475.http://www.ncbi.nlm.nih.gov/pubmed/16973019?tool=bestpractice.com