Clinical and demographic characteristics of migraine in urban children

To establish the frequency, symptoms, duration, and treatment methods of childhood migraine in an urban area.

Self-administered questionnaire survey. The questionnaire was designed according to criteria suggested by the International Headache Society (IHS).

In 1994, with the help of school officials in 41 elementary and middle schools in the Greater Cleve-land Area, 18,000 questionnaires were distributed to the parents of schoolchildren who ranged in age from 5 to 13 years.

Of the total 2572 respondents, 222 children (8.6%) met the IHS criteria for migraine. Male to female ratio was 1:1.2 (99:120), 65.8% had a positive family history of migraine, 30.6% had onset of migraine at 4 to 5 years of age, and 54.1% reported having an aura (71% of these were visual aura). The headaches were mostly pulsating, poorly localized, lasted about 2 to 12 hours, and were aggravated by motion, noise, and bright light. The associated symptoms were nausea, vomiting, photophobia, and phonophobia. During the attack, 43% of the migraineurs had to stay in bed, and 27% were unable to attend school. Only 19.8% of the migraineurs were diagnosed to have migraine by their physicians, and most of these had not received treatment.

This study in an urban area indicates that childhood migraine is a common, often underdiagnosed disorder that causes significant suffering for children and their families.