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Published on: June 2, 2014
Migraine and cranial autonomic symptoms in children and adolescents: a clinical study
V Raieli1, G Giordano2, C Spitaleri2
1Child Neuropsychiatry Unit, Di Cristina Hospital -ARNAS CIVICO Palermo, Palermo, Italy vraieli@libero.it.
Insights
Cranial autonomic symptoms are common in pediatric migraine, affecting 55% of young migraineurs. These symptoms correlate with more frequent migraine attacks, suggesting a role for the trigeminal-autonomic reflex in migraine.
Area of Science:
- Neurology
- Pediatrics
- Autonomic Medicine
Background:
- Cranial autonomic symptoms (CAS) in children with primary headaches are not well understood.
- Estimating the frequency of CAS in pediatric headaches is crucial for diagnosis and management.
Purpose of the Study:
- To determine the frequency of CAS in children experiencing primary headaches.
- To correlate CAS with key characteristics of migraine, such as attack frequency.
Main Methods:
- A questionnaire was used to collect data on CAS in children with primary headaches over two years.
- The study included 230 children with primary headaches, with a focus on migraineurs.
Main Results:
- CAS were significantly more frequent in children with migraine (55%) compared to those with other primary headaches (17.8%).
- CAS were associated with a higher frequency of migraine attacks (OR=2.6, CI=1.4-4.7).
Conclusions:
- CAS are common in pediatric migraine.
- The link between CAS and increased attack frequency suggests the trigeminal-autonomic reflex may play a role in migraine pathophysiology.
Abstract:
The frequency of cranial autonomic symptoms in children affected by primary headaches is uncertain. The aim of our study was to estimate the frequency of symptoms in pediatric headaches and correlate it with main migraine characteristics. A questionnaire investigating the presence of cranial autonomic symptoms was administered to all children with primary headache for 2 years. A total of 230 children with primary headache (105 males, 125 females) were included. Two hundred two children were affected by migraine and 28 (12.2%) by other primary headaches. Cranial autonomic symptoms were significantly complained by migraineurs (55% vs. 17.8%) (P < .001) and by children with higher frequency of migraine attacks (odds ratio = 2.6, confidence interval = 1.4-4.7, P = .001). Our findings show that cranial autonomic symptoms are rather common during pediatric migraine attacks. The association between cranial autonomic symptoms and higher frequency of attacks might suggest the role of the trigeminal-autonomic reflex in migraine pathophysiology.
