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Published on: September 1, 2018
Childhood periodic syndromes
Jean-Christophe Cuvellier1, Anne Lépine
1Division of Pediatric Neurology, Department of Pediatrics, Lille Faculty of Medicine and Children's Hospital, 59037 Lille, France. jc-cuvellier@chru-lille.fr
Insights
Pediatric periodic syndromes, precursors to migraine, present episodically with intervals of wellness. Early diagnosis and management, including lifestyle changes and antimigraine therapies, are crucial for affected children.
Area of Science:
- Neurology
- Pediatrics
- Gastroenterology
Background:
- Periodic syndromes in childhood can precede migraine development.
- These syndromes are characterized by episodic occurrences and periods of complete health.
Purpose of the Study:
- To review childhood periodic syndromes that are precursors to migraine, as defined by the International Classification of Headache Disorders.
- To outline diagnostic criteria, evaluation methods, and therapeutic strategies for these conditions.
Main Methods:
- Literature review of periodic syndromes in childhood.
- Analysis of diagnostic criteria and therapeutic recommendations from the International Classification of Headache Disorders, 2nd Edition.
Main Results:
- Key syndromes discussed include benign paroxysmal torticollis, benign paroxysmal vertigo, cyclic vomiting syndrome, and abdominal migraine.
- Ages of onset range from infancy (benign paroxysmal torticollis) to early childhood (abdominal migraine).
- Diagnostic challenges and the importance of appropriate evaluation are highlighted.
Conclusions:
- Early identification and management of these periodic syndromes are essential.
- Treatment involves reassurance, lifestyle adjustments, and both prophylactic and acute antimigraine therapies.
Abstract:
This review focuses on so-called "periodic syndromes of childhood that are precursors to migraine," as included in the second edition of the International Classification of Headache Disorders. Presentation is characterized by an episodic pattern and intervals of complete health. Benign paroxysmal torticollis is characterized by recurrent episodes of head tilt, secondary to cervical dystonia, with onset between ages 2-8 months. Benign paroxysmal vertigo presents as sudden attacks of vertigo lasting seconds to minutes, accompanied by an inability to stand without support, between ages 2-4 years. Cyclic vomiting syndrome is distinguished by its unique intensity of vomiting, affecting quality of life, whereas abdominal migraine presents as episodic abdominal pain occurring in the absence of headache. Their mean ages of onset are 5 and 7 years, respectively. Diagnostic criteria and appropriate evaluation represent the key issues. Therapeutic recommendations include reassurance, lifestyle changes, and prophylactic as well as acute antimigraine therapy.
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