Migraine is the most common acute and recurrent headache syndrome in children. It is characterized by periodic episodes of paroxysmal headache accompanied by nausea, vomiting, abdominal pain, and relief with sleep.
The epidemiology, pathophysiology, clinical features, and diagnosis of migraine headaches in children are reviewed here. Classification and treatment of migraine headaches in children and an approach to the general evaluation of headaches in children are discussed separately. (See "Classification of migraine in children" and "Management of migraine headache in children" and "Approach to the child with headache".)
Migraine occurs at all ages and may even begin in infancy [1,2]. The disorder begins before age 20 years in 50 percent of cases.
The onset of migraine tends to be earlier in boys than girls (7 versus 10 years of age) . Thus, before age seven, affected boys outnumber girls. The male preponderance persists until puberty; by 10 to 14 years of age, more females are affected [4,5].
The prevalence of migraine may be as high as 2.5 percent of children less than seven years of age (figure 1). By age 17 years, as many as 8 percent of males and 23 percent of females have experienced migraine [3,6,7]. Family history is positive in the majority of patients .