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Migraine in children--an evaluation of the IHS criteria
1Department of Child Neurology, University of Turku, Finland.
Insights
The International Headache Society (IHS) criteria for childhood migraine may exclude cases with shorter headache durations. Adjusting the minimum duration could identify more pediatric migraine patients.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Childhood migraine diagnosis relies on specific criteria.
- Previous definitions may differ from current International Headache Society (IHS) guidelines.
- The minimal headache duration is a key differentiating factor.
Purpose of the Study:
- To compare the new International Headache Society (IHS) criteria for childhood migraine with previously used definitions.
- To evaluate the impact of headache duration criteria on childhood migraine diagnosis.
- To assess the prevalence of migraine in children aged 8-9 years based on different criteria.
Main Methods:
- A postal questionnaire was administered to 3580 children aged 8-9 years.
- Participants reported headache attack frequency and characteristics.
- Data were analyzed to determine the number of children meeting IHS criteria versus previous definitions.
Main Results:
- 36.5% of children reported headache attacks.
- 95 children (2.7%) met the IHS criteria for migraine.
- 3% met the previously used Vahlquist definition, with some having shorter attacks.
- Lowering the IHS minimum duration from 2 hours to 1 hour or omitting it increased diagnosed cases to 114 and 127, respectively.
Conclusions:
- The current IHS criteria for childhood migraine may be too restrictive regarding headache duration.
- Modifying the minimum headache duration could improve the sensitivity of diagnostic criteria for pediatric migraine.
- Further research is needed to establish optimal diagnostic criteria for childhood migraine, considering symptom variability.
Abstract:
The purpose of the present study was to compare the new criteria by the International Headache Society (IHS) with criteria for the definition of childhood migraine previously used. In particular, we considered the problem of the minimally acceptable headache duration in children. In a postal questionnaire, 36.5% of 3580 children 8-9 years old reported headache attacks. Ninety-five children (2.7%) fulfilled the IHS criteria. Three percent fulfilled the previously used migraine definition of Vahlquist. Some of the children in the latter group had considerably shorter headache attacks than those of the IHS patients, but otherwise their symptoms were very similar. When the IHS criterion of headache attack duration was lowered from a minimum of 2 h to 1 h, or omitted, the number of migraine patients increased from 95 to 114 and 127, respectively.