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Published on: June 2, 2014
Migraine in children under 6 years of age: A long-term follow-up study
Francesca Marchese1, Luciana Rocchitelli1, Luca Maria Messina1
1Child Neuropsychiatry Unit Department Pro.M.I.S.E. "G D'Alessandro", University of Palermo, Italy.
Insights
Migraine starting in early childhood, before age 6, is linked to a poorer long-term outcome and persistent symptoms. This longest follow-up study highlights childhood migraine as an unfavorable prognostic factor.
Area of Science:
- Neurology
- Pediatric Neurology
- Headache Medicine
Background:
- Early-onset migraine in children is suspected to predict unfavorable outcomes.
- Limited follow-up studies exist, with most having short prospective periods.
Purpose of the Study:
- To conduct the longest follow-up investigation on childhood migraine onset.
- To assess the long-term prognosis of migraine starting before age 6.
Main Methods:
- Follow-up of 74 children diagnosed with migraine before age 6.
- Study conducted between 2016-2018, with initial referrals between 1997-2003.
- Diagnosis adherence to International Headache Society (IHS) criteria.
Main Results:
- 31% (23/74) of patients were followed up 15-21 years later.
- Seven patients were headache-free; 16 continued to have migraine.
- Migraine patients experienced altered pain localization (75%), allodynia (68.7%), and cranial autonomic symptoms (56.25%).
Conclusions:
- Very young migraine onset is an unfavorable prognostic factor for disease persistence.
- Clinical features like pain localization can change over time.
- Persistent migraine may correlate with increased allodynia.
Background:
Early starting of migraine seems predictive for less favorable outcome in later ages, however follow-up investigations are very few and all with short-term prospective period. We report here the longest follow-up study in a population of children presenting with migraine under the age of 6.
Methods:
We followed-up 74 children under 6 years of age, referred for headache to our department between 1997 and 2003. The study was carried out between October 2016 and March 2018. Headache diagnoses were made according to the IHS criteria.
Results:
23/74 patients, 31% of the original cohort, were found at follow-up in a period ranging between 15 to 21 years after the first visit. Seven of them were headache free. The remaining 16 patients had migraine. In the migraine group, the localization of pain changed in 75% of the subjects, 11/16 (68.7%) had allodynia and 9/16 (56.25%) had cranial autonomic symptoms.
Conclusions:
Our results suggest that the onset of migraine at very young age represents unfavorable prognostic factor for persistence of the disease at later ages. Some clinical features may change during clinical course, and the active persistence of the disorder may lead to an increase in allodynia.
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