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Published on: June 2, 2014
Migraine in children and adolescents: Assessment and diagnosis
Ishaq Abu-Arafeh1, Maria Morozova1
1Paediatric Neurosciences Unit, Royal Hospital for Children, Glasgow, United Kingdom.
Insights
Pediatric migraine requires a comprehensive assessment considering the child's entire life context. Early detection of red flags through careful history and examination is crucial for accurate diagnosis and management.
Area of Science:
- Neurology
- Pediatrics
- Clinical Assessment
Background:
- Migraine is a complex brain disorder influenced by biopsychosocial factors.
- Pediatric migraine presentation and management require consideration of the child's broader life context, including family, school, and development.
- Accurate diagnosis in children relies on detailed clinical history and physical/neurologic examination.
Conclusions:
- A thorough, biopsychosocial approach is vital for assessing and managing pediatric migraine.
- Skilled clinical assessment, including history and examination, is key to early detection and accurate diagnosis.
- Utilizing the International Classification of Headache Disorders ensures standardized and correct diagnosis in children and adolescents.
Abstract:
Migraine is a complex, multifactorial brain disorder, and its presentation, complications, and response to treatment often follow the biopsychosocial model. Therefore, assessment and management include the wider aspects of the child's life within the family, at school, with peers, and in relation to his/her neurologic and emotional development. The diagnosis of headache disorders in children relies heavily on taking a careful clinical history, carrying out an appropriate physical and neurologic examination and a skilled interpretation of the findings. This chapter discusses the peculiarities of migraine in children, the differences in presentation from that in adults, and the skills that are needed in assessing the children and adolescents with headache. There is also a brief review of the epidemiology of headache and migraine in children and adolescents and an introduction of the principles of a comprehensive clinical assessment of the impact of migraine on child's quality of life. Several important elements of the clinical history and the physical and neurologic examination will be illustrated to help in the early detection of red flags that may necessitate further assessment and/or investigations. At the end of the assessment, the clinicians will be able to employ the International Classification of headache Disorders and make the correct diagnosis.
