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Biomedical subjects

L Metsähonkala

Publications and source records attributed to L Metsähonkala.

17 recordsLinked to original sources
PubMed2001

Comorbidity of other pains in schoolchildren with migraine or nonmigrainous headache.

OBJECTIVE: To compare the occurrence of pain other than headache in prepubertal children with migraine and those with nonmigrainous headache. STUDY DESIGN: An unselected population-based prospective follow-up study on the occurrence of headache in school-aged children was carried out in 1290 children aged 8 to 9 years. The children (n = 725) who reported headache during the preceding 6 months were sent a more detailed questionnaire concerning the occurrence of pain other than headaches; 622 children (86%) returned an acceptably completed second questionnaire. Of them, 53 (8.5%) had migraine. Nonmigrainous headache was found in 460 children (74%). RESULTS: Children with migraine reported neck-shoulder pain, abdominal pain, back pain, and otalgia significantly more often than those with nonmigrainous headache. The median of the sum of other pains in children with migraine was significantly higher than that in children with nonmigrainous headache. The sum of other pains correlated positively with the frequency of nonmigrainous headache episodes (r =.40; 95% CI.31-.47), but there was no correlation between the sum of other pains and frequency of migraine attacks (r = -0.09; 95% CI -0.36-0.20). CONCLUSION: Children with migraine are more likely to report types of pain other than headaches, regardless of the frequency of attacks. Children with frequent nonmigrainous headaches also report higher frequencies of other types of pain.

Child↗
PubMed2000

Cerebral glucose metabolism in survivors of childhood acute lymphoblastic leukemia.

BACKGROUND: Cranial radiation therapy (CRT) has been suggested to be a principal factor responsible for long term neurocognitive deficits in survivors of acute lymphoblastic leukemia (ALL). However, neither reduction of the irradiation dose nor the elimination of irradiation entirely appear to have abolished neurocognitive impairment in long term ALL survivors. Positron emission tomography (PET) and [(18)F]-fluorodeoxyglucose (FDG) can be used to quantitate cerebral glucose metabolism, a potential indicator of treatment-induced adverse central nervous system (CNS) effects. The purpose of this study was to assess whether CRT is associated with defects in cerebral glucose metabolism in long term ALL survivors. The authors also studied whether chemotherapy and/or the severity of disease have deleterious effects on glucose metabolism. METHODS: Forty long-term survivors of childhood ALL were studied using FDG PET. All subjects went through an elaborate neurocognitive assessment. In 20 of these children, the prophylactic treatment of the CNS had been CRT combined with methotrexate (MTX), and it was MTX only in the remaining 20 children. RESULTS: No major differences were found in the regional cerebral glucose utilization or in neurocognitive performance between the irradiated and nonirradiated groups. A high leukocyte count at the time of diagnosis was found to be associated inversely with cerebral glucose utilization. CONCLUSIONS: CRT does not appear to affect cerebral glucose metabolism in long term survivors of ALL. By contrast, the association between the leukocyte count and glucose utilization implies that disease severity may be partly responsible for adverse CNS effects in long term survivors of childhood ALL.

Adolescent↗
PubMed2000

Predisposing and provoking factors in childhood headache.

OBJECTIVE: To study the differences in predisposing and provoking factors between childhood migraine and nonmigrainous headache. BACKGROUND: Information on the predisposing and provoking factors of headache could help to find ways to prevent it. Differences in predisposing and provoking factors between migraine and nonmigrainous headache are largely unknown. METHODS: An unselected, population-based, prospective, follow-up study on the occurrence of headache in schoolchildren was carried out in 1290 children aged from 8 to 9 years. The children who had reported headache during the 6 months prior to the study (n = 725) were sent a more detailed questionnaire about factors that might give rise to headache. Six hundred twenty-two (86%) children returned questionnaires that were completed to an acceptable degree. RESULTS: The occurrence of familial paroxysmal headache and unhappiness in the family independently predicted the occurrence of migraine in children, but this was not the case for nonmigrainous headache. CONCLUSIONS: In particular, the family occurrence of paroxysmal headache increases the risk of migraine in a child. The risk is still greater if their living conditions are experienced as unsatisfactory by the family.

Causality↗
PubMed1999

Cerebral blood flow and glucose metabolism in long-term survivors of childhood acute lymphoblastic leukaemia.

Central nervous system treatment for childhood acute lymphoblastic leukaemia (ALL) has been reported to cause changes in cerebral blood flow and glucose metabolism. Little is known about the association of these functional changes with neuropsychological defects and structural changes. The aim of the present study was to assess the relationship between changes in regional cerebral blood flow and glucose utilisation in long-term survivors of ALL, and the association of these functional abnormalities with neurocognitive and structural defects. 8 survivors of childhood ALL were studied with single photon emission tomography (SPECT) using Tc99m-ethyl cysteinate dimer (ECD) as tracer and with positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) as tracer. 8 healthy controls also underwent FDG-PET. All subjects also underwent magnetic resonance imaging and neuropsychological assessment 5 years after cessation of the therapy. Focal cerebral blood flow abnormalities were found in ECD-SPECT in 5 of the 8 survivors. Glucose utilisation appeared normal in the corresponding regions. However, glucose utilisation was decreased in thalamus and cerebellum in the survivors of ALL as compared with healthy controls. 3 patients had severe and 5 patients mild neurocognitive difficulties. The changes in cerebral blood flow and FDG uptake did not correspond neuroanatomically with the neurocognitive defects. Focal defects in cerebral blood flow in long-term survivors of ALL are not associated with changes in local cerebral glucose utilisation. Neurocognitive difficulties are not consistently associated with either changes in cerebral blood flow or with decreased glucose utilisation. Therefore, based on the present set of studies FDG-PET and ECD-SPECT cannot yet be recommended for the evaluation of long-term neurocognitive defects associated with treatment of ALL.

Adolescent↗
PubMed1999

School start and occurrence of headache.

OBJECTIVES: The purpose of the study was to examine the occurrence of childhood headache at the start of school. STUDY DESIGN: An unselected population-based population-based questionnaire study on the occurrence of headache was conducted in 1433 children between the ages of 6 and 7 years old (ranging from 6 years 8 months to 7 years 8 months) who started school in 1992. The first questionnaire was given within 3 months of school entry in 1992. Of 1433 children, 1290 responded satisfactorily to the second headache questionnaire at the end of the second school year. The children (n = 725) who had had headache in 1994 were sent a more detailed questionnaire concerning risk factors of headache. RESULTS: A significant increase in the incidence density of overall headache in children was found during the first 12 school months compared with the 6 months immediately before school started or with the subsequent 6 school months (13th-18th month). The increase was attributable to occasional headache. During the first school months, the frequency of headache increased in 20% of children who had had headache before the 6 months preceding the start of school. The mothers and fathers of 129 children who started to have headache after school entry had a higher socioeconomic status than the mothers and fathers of children who had headache before the start of school. No significant difference in family history of headache or school-related factors was found among children. Predictably, the incidence density of recurrent headache after school start was higher than before school start. However, occasional headache showed a distinct peak at school start but regained its initial level at the end of the second school year. CONCLUSION: School start appears to increase the incidence of overall headache (occasional headache in particular) in children, independent of other factors.

Child↗
PubMed1999

Increased brain glucose utilization in Salla disease (free sialic acid storage disorder).

UNLABELLED: Salla disease is an autosomal recessive lysosomal free sialic acid storage disorder characterized by psychomotor retardation and ataxia. MRI studies have revealed evidence of dysmyelination, but the biological mechanism of the brain dysfunction is unknown. METHODS: Nine patients with Salla disease (age 2.5 mo-42 y) presenting the disease in varying degrees of severity were studied by PET using 2-fluoro-2-deoxy-D-glucose (FDG) as a tracer. Local cerebral metabolic rates for glucose (LCMRGlc) in individual brain regions were compared with controls. RESULTS: The FDG PET results showed significantly increased LCMRGlc values in the frontal and sensorimotor cortex and especially in the basal ganglia of the patients. Cerebellar hypometabolism was present in all seven patients with marked ataxia, whereas the less severely affected patients without obvious ataxia had normal or even high glucose uptake in the cerebellum. CONCLUSION: The increased cerebral glucose utilization is a constant finding in Salla disease and may reflect the basic defect of the sialic acid metabolism in this disorder. The FDG PET findings in the cerebellum suggest a correlation between glucose uptake and the severity of the clinical symptoms.

Adolescent↗
PubMed1998

Social environment and headache in 8- to 9-year-old children: a follow-up study.

We studied the occurrence of migraine and nonmigrainous headache and the factors associated with headache in a group of 3580 children. These children belong to a 1-year age cohort which has been followed since birth. When the children were 8 to 9 years old, data on their headaches were gathered through a postal questionnaire. Ninety-five of the children (2.7%) had migraine and 977 (27.3%) reported non-migrainous headache at the age of 8 to 9 years. Thirty-four percent of the children with migraine had already had headache at the age of 5 years. Children with migraine and children with nonmigrainous headache both reported more often being bullied in school, stress in school, and problems in getting along with other children than children without headache. The association of stress in school with headache was strongest in girls with migraine, even though they reported the least difficulties in school subjects. As many as one third of the boys with migraine reported that they had problems with peer relationships.

Adaptation, Psychological↗
PubMed1997

Outcome of early school-age migraine.

We studied the outcome of migraine from early school-age to prepuberty in a group of 84 children. The children belonged to a population-based, unselected follow-up sample of a 1-year age cohort. At the age of 8 to 9 years, 95 (2.7%) children of this age cohort had migraine according to a postal questionnaire. At age 11 to 12 years, 84 of them were traced and interviewed face-to-face. Only four (4.8%) of these children no longer had headache. Fifty-three (63.1%) children had migraine. Seventeen (20.2%) had migraine-type headache which did not completely fulfil the International Headache Society criteria for migraine, seven (8.3%) children had episodic tension-type headache and three (3.6%) had other headache. Among the children who had migraine at age 11 to 12, boys had significantly more frequent migraine attacks than girls (mean 2.7/month versus 1.8/month; p = 0.016). They also used more drugs and were more frequently absent from school because of headache than girls, but these differences were not significant. Problems in the relationships between parents seemed to be another factor associated with frequent migraine.

Adolescent↗
PubMed1997

Headache diary in the diagnosis of childhood migraine.

The usefulness of a headache diary in the diagnosis of migraine and in the clarification of migraine symptoms was studied in 145 children. These children belong to a 1-year age cohort of 5356 children that has been followed since birth. The children were enrolled in the present study according to their headache status in a questionnaire study at the age of 8 to 9 years, at which time 50 children had migraine, 43 had nonmigrainous headache, and 52 did not have recurrent headache. Information on their present headache status was collected with a face-to-face interview at the age of 11 to 13 years and from a headache diary after the interview. The children kept the diary for 2 to 7 months. Altogether, 72 children had migraine according to the International Headache Society criteria for migraine, either in the interview or in the diary. Eight children were diagnosed only according to the diary (11.1%). Thirty-three children had both migraine attacks and nonmigrainous headache episodes according to the diary, even though they were able to report only one type of headache episode in the interview. The duration of headache episodes was underestimated in the interview, compared to the diary, in the children with migraine. Many children recognized new aura symptoms, associated symptoms, and characteristics of pain when they started to pay attention to these when filling in the diary during the follow-up period. The headache diary is useful in clarifying the features of headache attacks and in the diagnosis of headache types in children.

Adolescent↗
PubMed1996

CT, MRI, and PET in a case of intractable epilepsy.

We report the case of a child with drug-refractory partial epilepsy in whom computed tomography showed no abnormality and magnetic resonance imaging showed a noninvasive cystic lesion in the left hippocampus. The finding in the positron emission tomography study with L-[methyl-11C]-methionine as a tracer suggested a tumor. This finding was confirmed histologically.

Brain Neoplasms↗
PubMed1994

Migraine in children--an evaluation of the IHS criteria.

The purpose of the present study was to compare the new criteria by the International Headache Society (IHS) with criteria for the definition of childhood migraine previously used. In particular, we considered the problem of the minimally acceptable headache duration in children. In a postal questionnaire, 36.5% of 3580 children 8-9 years old reported headache attacks. Ninety-five children (2.7%) fulfilled the IHS criteria. Three percent fulfilled the previously used migraine definition of Vahlquist. Some of the children in the latter group had considerably shorter headache attacks than those of the IHS patients, but otherwise their symptoms were very similar. When the IHS criterion of headache attack duration was lowered from a minimum of 2 h to 1 h, or omitted, the number of migraine patients increased from 95 to 114 and 127, respectively.

Child↗
PubMedDate not supplied

Use of health care services in childhood migraine.

The use of health care services in childhood migraine was studied in a representative population sample of 53 children with migraine. These children belong to a 1-year age cohort that has been followed since birth. Migraine was diagnosed at the age of 8 to 9 years according to the International Headache Society criteria of migraine in 95 of 3580 children (2.7%). At the time of the present study, 84 of the 95 children were clinically examined at the age of 11 to 13 years. Fifty-three of them (62.4%) still had migraine and 32 did not. Of these 53 children, 31 (51.8%) had consulted a doctor because of headache. The most important factors linked to the consultation rate were aura symptoms and maximal frequency of attacks. The children who had consulted a doctor more often had nausea and more often came from densely populated areas. They had missed school days more often because of headache than those who had not consulted a doctor.

Acute Disease↗