Redefining Migraine without Aura in Children A 7-Year Study Based on ICHD 2
Objective: To document short duration (less than one hour) activity affected headaches in children without migraine diagnostic-associated features of nausea, vomiting, phonophobia and photophobia and thus to redefine current( ICHD 2 and 3 BETA) paediatric migraine diagnostic criteria.Objective: To document short duration (less than one hour) activity affected headaches in children without migraine diagnostic-associated features of nausea, vomiting, phonophobia and photophobia and thus to redefine current( ICHD 2 and 3 BETA) paediatric migraine diagnostic criteria.Background: Studies show that migraine in children are of shorter duration and when they present without associated features like nausea, vomiting, phonophobia or photophobia, diagnosis can be a real challenge as they miss two current migraine diagnostic criteria/group 14 is applied (headache unspecified / not elsewhere classified). This study is to document such short duration headaches in children without migraine diagnostic-associated features.Methods: 7 year prospective cohort study conducted on 1432 children, 5 to 15 years old with the following inclusion criteria:1) Recurrent short duration throbbing/non throbbing headaches (unilateral/bilateral / unilateral spreading bilaterally)2) Activity affected (motionless/lie down/sleep off),3) No nausea, vomiting, phonophobia or photophobia,4) Common/well known/local migraine triggers in this region of India precipitating them.5) One family member suffering from ICHD 2 1.1 (migraine without auras)/1.2 (migraine with auras)/ 1.6 (probable migraines).6) No other significant headache-related history and normal physical, neurological and neuro ocular examinations.Results: Duration of head pain: 5 minutes to 45 minutes. Common regional /well known migraine triggers: sun exposure, bus travel, missing meals, strenuous physical exercises and sleep disturbances. Family history: 83% (1188) mothers, 11% fathers (158) and 6% (86) siblings suffering from ICHD2, 1.1 (migraine without auras)/1.2 (migraine with auras)/1.6 (probable migraines).Conclusion: A new definition of paediatric migraine based on above findings will be extremely helpful for any clinician in a busy practice. Recurrent activity-affected headaches precipitated by known or regional migraine triggers and one family member suffering from migraine origin pain (1.1, 1.2, 1.6) in the absence of another disorder, should lead one to consider the diagnosis of migraine without aura in children.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.