Galinski M, Sidhoum S, Cimerman P, Perrin O, Annequin D, Tourniaire B. Early diagnosis of migraine necessary in children: 10-year follow-up. Pediatric Neurology Published Online: June 04, 2015 Publication stage: In Press Accepted Manuscript
Abstract
Background
The prevalence of migraine in the under 20 year-olds is 8%, with a mean age at onset of under 8 years. However, the long-term prognosis of migraine attacks has not been clearly established.
Objective
Our main objective was to evaluate disease course 10 years after migraine diagnosis in a cohort of children and adolescents.
Methods
Migraine was diagnosed in 1999 in a pediatric headache reference center using International Headache Society criteria. In 2009, all patients were interviewed by telephone on the persistence and characteristics of any headaches. The main end point was prevalence of persistent migraine attacks in 2009. Variables associated with persistent attacks were analyzed.
Results
Overall, 142 children were diagnosed with migraine in 1999. Of these, 84 were interviewed by telephone in 2009. In 1999, mean age was 11.6±3.1 years, 54% were male, 50% had migraine without aura. Migraine attacks were common (1-3 attacks/week in 38%). Mean age at onset was 7 years and 4 months (±3 years). In 2009, migraine prevalence was 39/84 (46% [95% CI 36-56]), 12 patients (14%) were headache-free, 62 patients (74%) had tension-type headaches that were isolated headaches in 33 (39%) cases. The rate of patients with at least one migraine attack per week fell from 37 to 8% (p=0.001) over the 10-year period. Age at the first visit to the center was significantly higher in 2009 migraine sufferers than non-sufferers (12.5±3.0 vs 10.9±3.1 years (p=0.02)). In multivariate analysis, age ≥12 years at the time of first presentation was the only significant factor associated with long-term chronic migraine (OR=3.0 [1.1-8.0]).
Conclusions
Ten years after first presentation, 46% of patients had migraine but the frequency of attacks had diminished. The only factor associated with chronic migraine was age ≥12 years at first presentationFrom the article:
Age at first presentation and mean time between migraine
onset and first visit were significantly higher in those still suffering from
migraine in 2009 than in non-sufferers (age: 12.5 ±3.0 vs 10.9 ±3.1 years,
p=0.02; time: 5.0 ±2.9 vs 3.9± 2.2 years, p=0.03). However, there was no
significant difference between the two groups in terms of patient age at
migraine onset (7.7±3.0 and 7.0±2.9 years, respectively, p=0.3).
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