Understanding the early signs of migraine in children can provide valuable insights into this neurological condition. This comprehensive overview explores several early life conditions linked to migraine, such as Cyclical Vomiting Syndrome, Abdominal Migraine, Benign Paroxysmal Torticollis, and Benign Paroxysmal Vertigo. We discuss the characteristics, common triggers, and diagnostic processes, while also providing guidance on treatment and prognosis. Whether you’re a parent or a healthcare professional, this guide will equip you with essential knowledge to manage and understand these early life expressions of migraine.
Which Early Life Conditions Are Related to Migraine?
Several early life conditions, known as “episodic syndromes that may be associated with migraine,” have been identified. These were previously called “childhood migraine equivalents” due to their association with migraine in adulthood and shared characteristics. According to the International Classification of Headache Disorders, these syndromes include:
These conditions affect 1-3% of children, typically between the ages of 2 to 8 years old, with an onset around 3-4 years old. While they often resolve with adolescence, some individuals may experience them into adulthood.
Other childhood conditions potentially related to migraine include infant colic and motion sickness, although these can also occur independently of migraine.
Common Features of These Disorders
These episodic syndromes share several key characteristics:
- Periodic Timing: Symptoms occur intermittently.
- Normalcy Between Attacks: Children feel normal between episodes.
- Triggers: Attacks can be triggered by factors that also trigger migraine, such as exhaustion, stress, lack of sleep, fasting, and certain foods.
- Family History: A significant percentage (65-100%) of affected children have a parent with migraine.
Children with these conditions are more likely to develop migraine as they grow older. Approximately 25% of children with migraine equivalents will develop migraine, compared to 15% in the general population. Additionally, paroxysmal torticollis and vertigo may be associated with cyclical vomiting and/or abdominal migraine, indicating an overlap among these syndromes.
Diagnosis of Migraine-Related Conditions
Diagnosing these conditions involves assessing symptoms and ruling out other potential causes. Collaboration among different specialists is crucial. Awareness of these syndromes facilitates accurate diagnosis, minimizes unnecessary tests, and improves treatment outcomes. For children with a strong family history of migraine, invasive testing may be unnecessary, and a pediatric neurologist can often make the diagnosis.
Available Treatments
The primary treatment goal is to establish a diagnosis and reassure patients and their families that these conditions are not dangerous. Treatment strategies include:
- Eliminating Triggers: Identifying and avoiding factors that trigger attacks.
- Lifestyle and Behavioural Strategies: Implementing habits to manage and reduce symptoms.
- Acute Treatment: Managing specific attacks with appropriate interventions.
- Long-Term Prevention: In some cases, medications may be necessary for ongoing prevention.
For more detailed information on treatments for each syndrome, refer to the respective posts Cyclic Vomiting Syndrome, Abdominal Migraine, Benign Paroxysmal Torticollis, Benign Paroxysmal Vertigo, and Infant Colic.
Prognosis: Will My Child Develop Migraine?
Most of these syndromes improve or resolve over time. However, some children with abdominal migraine and cyclic vomiting syndrome may continue to experience symptoms into adulthood. While these syndromes are considered precursors to migraine, not all children will develop migraine in the future.
Here are some statistics on the likelihood of developing migraine:
Different studies show varying results, so predictions are not absolute.
References
- Gelfand A. Episodic syndromes of childhood associated with migraine. Current Opinion Neurology. 2018;31:281-285.
- Lagman-Bartolome AM, Lay C. Pediatric Migraine Variants: A review of epidemiology, diagnosis, treatment, and outcome. Current Neurology and Neuroscience. 2015;12:1-14.
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