Hemiplegic Migraine in Children and Adolescents
Ilaria Bonemazzi1, Francesco Brunello1, Jacopo Norberto Pin1
1Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy.
Insights
Pediatric hemiplegic migraine (HM) affects boys and girls equally and may present with early neurological symptoms. While attacks can be severe initially, they often decrease in frequency and intensity over time.
Area of Science:
- Neurology
- Pediatric Neurology
- Genetics
Background:
- Hemiplegic migraine (HM) is a rare neurological disorder with early onset, yet pediatric cases are understudied.
- Understanding the unique features of HM in children is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review and describe the specific characteristics of hemiplegic migraine in the pediatric population.
- To highlight differences between pediatric and adult HM presentations.
Main Methods:
- A narrative review of 14 studies on pediatric HM, selected from 262 relevant papers.
- Systematic literature search and synthesis of findings related to pediatric HM.
Main Results:
- Pediatric HM affects males and females equally, unlike in adults.
- Early transient neurological symptoms may precede HM onset in children.
- Non-motor auras are less common in children than adults.
- Sporadic pediatric HM cases experience longer, more severe attacks than familial cases.
- HM attack frequency, intensity, and duration tend to decrease over time.
- Most pediatric HM patients have a favorable outcome, though comorbidities can occur.
Conclusions:
- Further research is needed to fully define the clinical phenotype and natural history of pediatric HM.
- Refining genotype-phenotype correlations is essential for understanding HM pathophysiology, diagnosis, and prognosis.
- Improved knowledge is required to enhance the diagnosis and management of pediatric HM.
Background:
Only a few studies have focused on hemiplegic migraine (HM) in children despite its early age of onset. The aim of this review is to describe the peculiar characteristics of pediatric HM.
Methods:
This is a narrative review based on 14 studies on pediatric HM selected from 262 papers.
Results:
Different from HM in adults, pediatric HM affects both genders equally. Early transient neurological symptoms (prolonged aphasia during a febrile episode, isolated seizures, transient hemiparesis, and prolonged clumsiness after minor head trauma) can precede HM long before its onset. The prevalence of non-motor auras among children is lower than it is in adults. Pediatric sporadic HM patients have longer and more severe attacks compared to familial cases, especially during the initial years after disease onset, while familial HM cases tend to have the disease for longer. During follow-up, the frequency, intensity, and duration of HM attacks often decrease. The outcome is favorable in most patients; however, neurological conditions and comorbidities can be associated.
Conclusion:
Further studies are needed to better define the clinical phenotype and the natural history of pediatric HM and to refine genotype-phenotype correlations in order to improve the knowledge on HM physiopathology, diagnosis, and outcome.
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