Children’s migraine – clinic, diagnosis, options
A common cause of acute headaches in children is infectious diseases, especially viral etiology, as well as sinusitis. Children with post-traumatic and progressive headaches, a history of neurological diseases (such as hydrocephalus), as well as neurological pathology revealed in the course of the neurological examination, are shown to have neuroimaging.
As in adults, children with a change in the nature of chronic headaches, with chronic progressive headaches or with the ineffectiveness of traditional methods of treatment may require additional general somatic and neurological examination, including visualization methods.
Migraine in children is characterized by some features. Despite the fact that in adults and in children it causes gross maladjustment, the manifestations of migraine in children are distinguished by the following symptoms:
• two-way localization;
• short duration (often less than 2 hours);
• lack of complaints of light and sound fear.
In children, migraine pain is usually diffuse, localized in the fronto-temporal region. Occipital localization of pain for children is not typical, and therefore requires additional examination.
When examining high school students migraine was detected in every fifth. Among those who were diagnosed with “migraine”, symptoms characteristic of adults (especially one-sided localization, concomitant nausea and debilitating pain) occurred in a smaller part of schoolchildren. A special study of children with migraine showed that typical for adults symptoms are practically absent in children, especially in the younger age group.
In comparison with adolescents, younger children indicated a shorter duration of headaches (9 hours compared to 15 hours), their uncertain nature (“it hurts somewhere there”: 19 versus 8%) and frontal localization (56 versus 46%) . The remaining comparative signs are shown in the table. In another study involving migraine sufferers aged 9–16, an analysis of their diaries revealed that every fifth time was less than 1 hour for migraine attacks.