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Migraine in children
N Thilothammal1, M Chellaraj, K Banu
1Clinical Epidemiology Unit, Institute of Child Health, Madras.
Insights
Common migraine is more frequent in children than classic migraine. Clinical diagnosis is key, as electroencephalography (EEG) changes are non-specific and biochemical tests are insensitive for diagnosing childhood migraine.
Area of Science:
- Neurology
- Pediatrics
- Clinical Diagnostics
Background:
- Migraine is a common neurological disorder in children.
- Understanding the clinical presentation and diagnostic markers is crucial for effective management.
Purpose of the Study:
- To describe the clinical profile of childhood migraine.
- To evaluate electroencephalographic (EEG) changes and urinary 5-hydroxy indole acetic acid (5-HIAA) levels in pediatric migraine patients.
Main Methods:
- A descriptive study involving 50 children diagnosed with migraine based on Prensky's criteria.
- Assessment included clinical evaluation, EEG recordings, and urinary 5-HIAA screening during headache-free and headache periods.
Main Results:
- Common migraine (46/50) was more prevalent than classic migraine (4/50).
- Physical strain and psychological stress were identified as primary triggers.
- Abnormal EEG findings were observed in 35% of patients.
- Urinary 5-HIAA was largely negative, with only one positive result during a headache episode.
Conclusions:
- Clinical criteria remain the definitive method for diagnosing childhood migraine.
- EEG changes in migraine are non-specific and not suitable for diagnostic purposes.
- Biochemical analysis for 5-HIAA is neither sensitive nor cost-effective for diagnosing pediatric migraine.
Abstract:
A descriptive study was carried out to find out the clinical profile, and electroencephalographic (EEG) changes in children with migraine. Screening for urinary excretion of 5-hydroxy indole acetic acid (5-HIAA) was carried out. Fifty children suffering from migraine as per Prensky's criteria were recruited over a period of 1 year. Forty six children were suffering from common migraine and 4 had classic migraine. The most common precipitating factors were physical strain and psychological stress like examination fear, fear of teacher and fights with friends. Abnormal EEG recordings were seen in 35 out of 50 patients. Urine samples taken during the headache free period were negative for 5 HIAA. Among the samples taken during the episode of headache, only 1 was positive for 5-HIAA. It is concluded that common migraine is more prevalent than classic migraine. Clinical criteria is the only way of diagnosing migraine. Since EEG changes are non-specific, this cannot be used as a diagnostic test. Biochemical analysis is expensive and less sensitive.