편두통으로 안과에 의뢰된 소아의 임상분석
Clinical Characteristics of Children Diagnosed with Migraine
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목적: 편두통으로 안과에 의뢰된 소아의 시각증상, 두통의 양상 및 안과 소견을 분석하고자 하였다. 대상과 방법: 소아청소년과에서 병력, 신경학검사, 뇌자기공명영상촬영, 혈청검사 및 뇌척수액검사 등을 통해 기질적 이상 없이 편두통으로 진단받고 내원한 소아 31명을 대상으로 두통의 양상, 동반증상 및 안과검사 등의 의무기록을 후향적으로 분석하였다. 결과: 평균나이는 10.8세(5-17세)이며, 남자 16명, 여자 15명이었다. 두통의 발현 시기는 평균 9세였다. 동반된 시각조짐(visual aura)이나타난 소아는 19명(61.3%)이었으며, 시야흐림(19.4%), 단안 시력손실(19.4%), 섬광(12.9%), 암점(6.4%), 환시(3.2%) 순으로 관찰되었다. 최대교정시력은 0.97 ± 0.08, 안압은 16.13 ± 3.53 mmHg였다. 사시검사는 정상이었으며 시야검사에서는 전반적인 감도저하와 비특이적인 암점을 보이는 예를 제외하고 이상소견이 없었다. 결론: 편두통으로 안과를 내원한 환아에서 대부분 동반된 시각증상이 안과적 이상과 관련이 없음을 확인할 수 있었으며 세심한 안과검사를 시행한 후에 이를 환자나 보호자에게 설명하고 안심시키는 것이 중요하겠다.
Abstract
Purpose: To analyze the clinical characteristics of visual symptoms, aspects of headache, and ophthalmologic features in children diagnosed with migraine. Methods: The medical records of 31 Korean children who had been diagnosed with migraine by pediatric neurologists were retrospectively reviewed and visual symptoms and ophthalmologic examinations were evaluated. Results: The mean age of the 31 patients was 10.8 years (range, 5-17 years). The mean age of onset of headache was 9years (range, 4-15 years). Nineteen patients (61.3%) had the associated visual aura. Visual symptoms of the 19 patients included blurred vision, unilateral vision loss, flickering lights, scotoma, and visual hallucination in descending order. However, there was no specific abnormality observed on thorough ophthalmologic examinations. Conclusions: Most of the children diagnosed with migraine did not show any ophthalmologic problems. Careful ophthalmologic examination with an understanding of migraine should be performed and reassurance to patients may be beneficial.
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