Vomiting and migraine

Eidlitz-Markus T, Haimi-Cohen Y, Zeharia A. Vomiting and migraine-related clinical parameters in pediatric migraine. Headache. 2017 May 7. doi:10.1111/head.13109. [Epub ahead of print]

Abstract

OBJECTIVE/BACKGROUND:

To investigate the characteristics of vomiting in pediatric migraineurs and the relationship of vomiting with other migraine-related parameters.

METHODS:

The cohort included children and adolescents with migraine attending a headache clinic of a tertiary pediatric medical center from 2010 to 2016. Patients were identified by a retrospective database search. Data were collected from medical files. The presence of vomiting was associated with background and headache-related parameters.

RESULTS:

The study group included 453 patients, 210 boys (46.4%) and 243 girls (53.6%), of mean age 11.3 ± 3.7 years. Vomiting was reported by 161 patients (35.5%). On comparison of patients with and without vomiting, vomiting was found to be significantly associated with male gender (54% vs 42.1%, P < .018), younger age at migraine onset (8.0 ± 3. years vs 9.6 ± 3.7 years, P < .001), younger age at clinic admission (10.5 ± 3. years vs 11.6 ± 3.6 years, P = .002), higher rate of awakening headache (64.1% vs 38.7%, P < .001), lower headache frequency (10.5 ± 10.3 headaches/month vs 15.0 ± 11.7 headaches/month, P < .001), higher rate of episodic vs chronic migraine (67% vs 58.7%, P < .001), and higher rates of paternal migraine (24.1% vs 10.1%, P < .001), migraine in both parents (9.3% vs 3.1%, P = .007), and migraine in either parent (57.5% vs 45.5%, P = .02).

CONCLUSIONS:

The higher rate of vomiting in the younger patients and the patients with awakening pain may be explained by a common underlying pathogenetic mechanism of vomiting and migraine involving autonomic nerve dysfunction/immaturity. The association of vomiting with parental migraine points to a genetic component of vomiting and migraine. It should be noted that some of the findings may simply reflect referral patterns in the tertiary clinic.

______________________________________________________________________

Aim of this study is to examine the characteristics of vomiting in pediatric migraineurs and the relationship of vomiting with other migraine–related parameters. In the younger patients and the patients with awakening pain, the higher rate of vomiting may be explained by a common underlying pathogenetic mechanism of vomiting and migraine involving autonomic nerve dysfunction/immaturity. The relationship of vomiting with parental migraine points to a genetic component of vomiting and migraine. In the tertiary clinic, it should be noted that some of the findings may simply reflect referral patterns.

Methods

The physicians enrolled children and adolescents with migraine attending a headache clinic of a tertiary pediatric medical center from 2010 to 2016.

They identified patients by a retrospective database search.

They collected data from medical files.

In this study, the presence of vomiting was associated with background and headache-related parameters.

Results

A total of 453 patients were included, 210 boys (46.4%) and 243 girls (53.6%), of mean age 11.3 ± 3.7 years.

161 patients (35.5%) reported vomiting.

Vomiting was found to be significantly associated with male gender (54% vs 42.1%, P < .018), younger age at migraine onset (8.0 ± 3. years vs 9.6 ± 3.7 years, P < .001), younger age at clinic admission (10.5 ± 3. years vs 11.6 ± 3.6 years, P = .002), higher rate of awakening headache (64.1% vs 38.7%, P < .001), lower headache frequency (10.5 ± 10.3 headaches/month vs 15.0 ± 11.7 headaches/month, P < .001), higher rate of episodic vs chronic migraine (67% vs 58.7%, P < .001), and higher rates of paternal migraine (24.1% vs 10.1%, P < .001), migraine in both parents (9.3% vs 3.1%, P = .007), and migraine in either parent (57.5% vs 45.5%, P = .02) on comparison of patients with and without vomiting.

https://www.mdlinx.com/neurology/medical-news-article/2017/05/15/pediatric-migraine-vomiting-migraine/7165927/?category=latest&page_id=2