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Classification of migraine in children

Hope O'Brien, MD, FAHS
Section Editors
Marc C Patterson, MD, FRACP
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD


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.

This topic will review the classification of migraine in children. Other aspects of migraine are discussed separately. (See "Pathophysiology, clinical features, and diagnosis of migraine in children" and "Acute treatment of migraine in children".)


The 1988 classification of headaches by the International Headache Society (IHS) [1] did not specifically address children [2]. This system replaced the terms "classic and common" with the terms "with and without aura." Migraine was classified into migraine with aura, migraine without aura, complicated migraine, and migraine variants.

In a 2004 revision of headache classification, the term "Complicated migraine" was replaced by "Complications of migraine" [3]. The 2004 and 2013 revisions also reclassified some syndromes unique to children that historically were considered manifestations of migraine. These syndromes – cyclical vomiting, abdominal migraine, benign paroxysmal vertigo of childhood, and benign paroxysmal torticollis – are usually associated with a positive family history and often evolve into more characteristic migraine symptoms with age. They were classified in 2004 as "childhood periodic syndromes that are commonly precursors of migraine" [3]. In 2013, they were reclassified as "Episodic syndromes that may be associated with migraine" [4]. (See 'Episodic syndromes that may be associated with migraine' below.)

Some of the other disorders discussed here, including Alice in Wonderland syndrome and confusional migraine, are not addressed in the International Classification of Headache Disorders system [4]. (See 'Other pediatric migraine variants' below.)

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Literature review current through: Nov 2017. | This topic last updated: Mar 26, 2017.
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