Influence of allergic rhinitis in children and adolescents with recurrent headache

Migraine and allergies are a common occurrence. The aim of this study was to investigate the relationship between respiratory allergy and migraine in childhood.

We screened 800 children for headache and its characteristics. After that we investigated the presence of allergy performing prick tests, rhinoscopy, endoscopy, rhinomanometry, cytology and mucociliary clearance tests.

Out of 800 children screened, 96 suffered from headache. Among these, 67 suffered from both headache and allergy. We found a significant correlation between allergy and headache onset in the morning and headache onset in the evening in non-allergic subjects. The average duration of a headache attack was independent from the presence of allergy, as well as the frequency of the cephalalgy attacks, and location of the pain. Prodromal symptoms connected with headache were reported to be: dizziness, aura, sparkling scotoma, nausea and vomiting, and they were associated with absence of allergy. We also found a relationship between female gender and headache onset, but in teenagers only. Paracetamol or FANS were used in the majority of cases, but antihistamine therapy and/or topical nasal sprays were also reported.

For an effective diagnostic and therapeutic approach to migraine, the pediatrician should take into account atopy and its related allergic manifestations requiring a consultation with an otorhinolaryngologist or allergist if necessary. Our findings also stress the potential role of medicines that are not usually administered in migraine attacks, such as antihistamines or topical decongestant nasal sprays.