migraine emedicine pediatrics

Overview of Pediatric Migraine
Migraines are incapacitating, throbbing headaches frequently located in the temples or frontal head regions. In children, the headaches are often bilateral (frontotemple) and may be nonthrobbing. Aura is infrequent prior to age 8 years. During the migraine episode, the child often looks ill and pale. Nausea and vomiting are frequent, particularly in young children. Patients avoid light (photophobia), noise (phonophobia), strong odors, and movement. Relief typically follows sleep.

Initial evaluation focuses on excluding other conditions. Management consists of identifying triggering factors, providing pain relief, and considering prophylaxis.

Migraine is a common disorder among the young. Estimates indicate that 3.5-5% of all children will experience recurrent headaches consistent with migraine. As in adults, most children (approximately 60%) have migraine without aura. Approximately 18% have only migraine with aura, 13% have both, and 5% experience only aura.

Several conditions that are relatively common in the pediatric population and are thought to be variations and/or precursors of migraine include the following:

Benign paroxysmal vertigo
Cyclic vomiting
Paroxysmal torticollis
Transient global amnesia (rare in children)
Acute confusional migraine
For other discussions on migraine headaches, see the overview topic Migraine Headaches, as well as the articles Migraine Variants and Migraine-Associated Vertigo.