Migraine in children: a medical and psychiatric study

Forty-seven migrainous children were examined medically, neurologically and psychiatrically and compared with matched controls from a dental clinic. One in six children suffered from more than one type of migraine. There was a wide variation in age of onset and the frequency and duration of attacks varied considerably. An "emotional upset" was the most frequently reported (86%) precipitating factor. Most children responded to simple therapeutic measures and detailed instructions about the timely use of medication. A significantly higher proportion of migrainous children than their controls showed signs of a neurotic disorder (mainly anxiety or depression) and had had a higher prevalence of neurotic disorder in the previous year. This increased prevalence was found to be associated with a disturbed parental relationship and certain factors related to their mothers (age, "malaise" score). A prospective study of an epidemiological sample based on systematic observation rather than recollections and opinions is likely to yield more conclusive results.