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Natural History of Migraine in Childhood
MA Hernandez-Latorre and M Roig
Posted: February 2003  
Cephalalgia 2000; 20:573-579

Epidemiological studies have shown that 3-7% of the pediatric population suffer from migraine. Despite this high prevalence, little has been published about the natural history of migraine or of its prognosis. The objectives of this study were: (i) to outline the natural history of migraine in childhood; and (ii) to identify early predictors of an unfavorable clinical evolution. A prospective, longitudinal, 10-year follow-up study was conducted of the clinical evolution of 181 pediatric patients with migraine. Data analysis was performed by statistical significance and logistic regression tests. In our study 24.3% of children with migraine had their onset before age 6 years and another 57% between 6 and 10 years of age. A positive family history of migraine was recorded in 77.5%. Eighty-eight percent of patients followed a favorable clinical course. The remaining 12% of patients had to be placed on prophylactic treatment owing to the increasing of their headache. Of all parameters investigated, the age of onset was the only statistically significant predictor of an unfavorable clinical evolution. We conclude: (i) most patients with migraine headache starting in childhood do not require prophylactic treatment; (ii) the earlier the disease begins the more likely is an unfavorable clinical course; (iii) genetic factors play an important role in the phenotypic expression of the disease; and (iv) our study suggests the existence, at least, of two different populations among childhood migraine patients.