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Kids' drawings help doctors diagnose migraines

(CHICAGO) - Children who drew images of their headache pain helped doctors better diagnose and treat migraines, showing that pictures sometimes speak louder than words, a study says.

A 10-year-old boy drew a frowning person playing the drums inside a big head, and a 9-year-old boy drew a hammer and chisel pounding crevices into the top of his head. Both were among pictures by 226 children complaining of headaches.

Pediatric neurologists who analyzed the pictures came to the same diagnoses as a doctor who did regular clinical analysis in nearly nine of 10 cases, the study found.

As many as two-thirds of children complain of headaches severe enough to seek medical attention, but diagnosing them can be difficult because there's no definitive test, said Dr. Carl Stafstrom, a University of Wisconsin neurologist who led the study. He said the diagnosis is made based on the patient's symptoms and medical history, and is subject to a doctor's training and judgment.

In addition, children of all ages often have difficulty expressing their symptoms verbally _ a problem drawings can help solve.

``It's cheap ... and very valuable,'' Stafstrom said.

An accurate diagnosis is critical, because treatment differs depending on the headache cause, said Stafstrom, whose study appears in the March issue of Pediatrics.

For example, migraines often are treated with prescription drugs, but over-the-counter medication such as ibuprofen often is sufficient for tension headaches, he said.

In the study, patients aged 4 to 19 referred for headaches to a Tufts University neurology clinic drew pictures to describe their pain. Neurologists scored the drawings as migraine or non-migraine, which were then compared with a standard clinical diagnosis from a different doctor.

Pictures featuring drawings consistent with migraine pain, such as pounding hammers and sparkling halo-like auras above the eyes, matched the clinical diagnoses in 87 percent of the cases.

Drawings with nonspecific pain such as a 17-year-old girl's picture of her head being squeezed by a rope represented non-migraine pain such as tension headaches. These drawings matched the non-migraine diagnoses in nearly 91 percent of the cases.

The researchers said drawings alone shouldn't be used to diagnose, but could be done in the waiting room before headache patients are examined.

``For the vast majority of children, headache drawing is an enjoyable exercise that allows the opportunity to express their symptoms and feelings and may afford greater insight into their pain,'' they said.


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