Stability of Pediatric Migraine Subtype After a 5-year Follow-Up

Area of Science:

• Neurology
• Pediatric Neurology
• Headache Medicine

Background:

• Migraine is a common neurological disorder with onset often occurring in childhood or adolescence.
• Understanding the long-term prognosis of pediatric migraine subtypes is crucial for effective management.
• Previous studies have limited data on the 5-year outcomes of childhood-onset migraine subtypes.

Purpose of the Study:

• To assess the 5-year follow-up outcomes of migraine subtypes diagnosed in childhood or adolescence.
• To identify potential prognostic factors influencing the long-term course of pediatric migraine.

Main Methods:

• A cohort of 343 patients diagnosed with migraine without aura (MO), migraine with aura (MA), or both (MO+MA) according to ICHD-II criteria were contacted.
• Structured follow-up headache interviews were conducted via phone after a 5-year period.
• Outcomes assessed included headache-free status, transformed headache diagnoses, and persistent migraine diagnoses.

Main Results:

• At 5-year follow-up, 22.7% of patients were headache-free, and 14.1% had transformed diagnoses (tension-type or chronic daily headache).
• A significant majority (63.3%) still met criteria for migraine (ICHD-II 1.1 or 1.2).
• Patients remaining migraineurs at follow-up were older at baseline; persistence rates varied by subtype (55.2% for MO, 95.1% for MA, 31.1% for MO+MA).

Conclusions:

• Childhood-onset migraine frequently persists into adulthood, with migraine with aura showing the highest diagnostic stability.
• A notable proportion of pediatric migraineurs may develop transformed headache disorders or achieve headache remission.
• Baseline age and specific migraine subtype are important factors in predicting 5-year outcomes for pediatric migraine patients.