What is the role of genetics in the etiology of pediatric migraine headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Migraine headaches may also have a genetic predisposition; nearly 70% of pediatric patients with migraine have a family history of migraine headache. Some individuals with familial hemiplegic migraine (FHM), a rare migraine subtype, have been found to have several genetic mutations in ion channels responsible for neurotransmitter release within the CNS, which may ultimately affect cortical excitability. [8]

In 1993, a gene mutation was found on chromosome 19, locus p13, in a pedigree experiencing FHM. Later, hemiplegic migraine in other families was mapped to chromosomes 1 and 2. At this time, 3 genes have been discovered, leading to following categories of FHM:

  • FHM I (locus 19, q 13) - Codes for the calcium channel CACNA1A gene

  • FHM II (locus 1, q 21) - Codes for the Na-K ATPase ATP1A2 gene [9]

  • FHM III (locus 2, q 24) - Codes for the sodium channel SCN1A gene [10]

Defects in ion channels resulting in excessive glutamate activity explain the effect of the mutations, which play a role in the aura. Cases of migraine due to a single mutation remain the exception. [11, 12]

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