Which clinical history findings are characteristic 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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Answer

Symptoms vary according to the type of migraine a patient has. Many children with migraines have a previous history of motion sickness, paroxysmal dizziness, or vertigo. Clinicians should suspect migraine headache in any child who presents with recurrent episodes of incapacitating headaches. Nearly 70% of pediatric patients have a family history of migraine headache.

A possible relationship exists between children who have cyclic vomiting syndrome and migraine headache. A genetic predisposition to develop migraine headaches appears to exist for patients with cyclic vomiting syndrome and their family members. Patients with cyclic vomiting syndrome, their mothers, and grandmothers may have a prevalence of migraine headache that is about twice that of the general population.

Many children with migraine will have some type of premonitory symptoms before the onset of headache. Some of these premonitory symptoms include irritability, fatigue, and changes in facial expression. [36] The recognition of these subtle premonitory symptoms is helpful in the initiation of abortive therapy.

A study by Gelfand et al of 154 infant-mother pairs indicated that infants born to mothers with a history of migraine headaches have a 2.6 times greater risk of developing colic. As a result of this finding, the investigators suggested that migraine may manifest early as colic. [37]

Common differences between pediatric and adult presentation of migraine include, in children, include lack of throbbing, absence of lateralization, and shorter duration of the attack. [1, 38]


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