Migraine Headaches in Children

Abstract

Headache, especially migraine, is a common medical complaint that has confounded physicians since ancient times. Hippocrates, about 500 BC, is credited with describing symptoms we now associate with migraine. Galen, a Greek physician in the second century AD, recognized the unilateral feature of these headaches and coined the term "hemicrania." Migraine is a French word that was derived from the Latin term for hemicrania. In the US it is estimated that 8.7 million females and 2.6 million males suffer from disabling migraine. The occurrence of migraine is greatest in adulthood, but this disorder is one of the most common causes of headache in children as well. In a 14-year longitudinal study of more than 9000 school children, Billie reported that 5% had had migraine attacks by 15 years of age. A recent population-based study in Olmsted County, Minnesota, suggests an even greater incidence in this age range. For example, the highest incidence of newly diagnosed migraine headaches appearing in males, 246 per 100 000 person-years, occurred in those aged 10 to 14 years. This review is directed toward the identification, classification, pathophysiology, and management of migraine in children and adolescents. Readers are referred to several recent articles for more general discussions of chronic recurrent headaches in childhood (see Suggested Reading).