Migraine-related symptoms in childhood.
ABSTRACT Periodic disorders of childhood often represent precursors of migraine. As we advance our knowledge of migraine and its complicated phenotypic presentation in childhood, we have noted the similarities in overlapping symptoms of children presenting with childhood periodic syndromes. There is often a positive family history of migraine in children that present with periodic syndromes. There is a known transformation of periodic syndromes from childhood into adult migraine with and without aura phenotype. There has been an evolution of our understanding of what was initially referred to as periodic symptoms of childhood and more recently been called childhood periodic syndromes and is now evolving into the terminology of episodic symptoms that are associated with migraine. International classification of headache disorders has been instrumental in the evolution of the classification of headache and children adults. The most recent classification utilizes and replaces the periodic symptom terminology with episodic symptoms that will no longer be limited to just childhood. This article will address the evolution of our understanding of the diagnostic criteria, pathophysiology and management of the episodic syndromes that may be associated with migraine.
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ABSTRACT: The clinical expression of migraine is significantly impacted by dietary and gastrointestinal issues. This includes gut dysfunction during and between attacks, food triggers, increase in migraine with obesity, comorbid GI and systemic inflammation influenced by diet, and specific food allergies such as dairy and gluten. Practitioners often encourage migraineurs to seek consistency in their lifestyle behaviors, and environmental exposures, as a way of avoiding sudden changes that may precipitate attacks. However, rigorous evidence linking consistency of diet with improvement in migraine is very limited and is, at best, indirect, being based mainly on the consistency of avoiding suspected food triggers. A review of current data surrounding the issue of dietary consistency is presented from the perspective of migraine as an illness (vulnerable state), as a disease (symptom expression traits), and with a view toward the role of local and systemic inflammation in its genesis. Firm recommendations await further investigation.Current Pain and Headache Reports 11/2013; 17(11):373. DOI:10.1007/s11916-013-0373-4 · 2.26 Impact Factor
Article: Sex and the Migraine Brain[Show abstract] [Hide abstract]
ABSTRACT: The brain responds differently to environmental and internal signals that relates to the stage of development of neural systems. While genetic and epigenetic factors contribute to a premorbid state, hormonal fluctuations in women may alter the set point of migraine. The cyclic surges of gonadal hormones may directly alter neuronal, glial and astrocyte function throughout the brain. Estrogen is mainly excitatory and progesterone inhibitory on brain neuronal systems. These changes contribute to the allostatic load of the migraine condition that most notably starts at puberty in girls.Neurobiology of Disease 08/2014; 68. DOI:10.1016/j.nbd.2014.03.008 · 5.20 Impact Factor
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ABSTRACT: Background Migraine equivalents are common clinical conditions without headache component, occurring as repeated attacks with complete remission between episodes. They include abdominal migraine, cyclical vomiting, benign paroxysmal vertigo, and benign paroxysmal torticollis. Other clinical entities, such as motion sickness and limb pain have been associated with migraine. We aimed to investigate the migraine equivalents prevalence in a large population of children referred to a pediatric headache centre and to reveal a possible relationship between migraine equivalents and headache features. Methods A total of 1.134 of children/adolescents (73.2% with migraine and 26.8% with tension-type headache) was included. Patients were divided into two groups according to the attack frequency (high and low). Pain intensity was rated on a 3-levels graduate scale (mild, moderate and severe pain). Results Migraine equivalents were reported in 70.3% of patients. Abdominal migraine (48.9%), limb pain (43.9%), and motion sickness (40.5%) were the most common migraine equivalents. While headache type (migraine or tension-type headache) did not correlate with migraine equivalents presence (χ2=33.2; P=0.27), high frequency of headache attacks correlated with migraine equivalents presence. Moreover, migraine equivalents showed a protective role for some accompanying symptom of the headache attack. Conclusions Our results suggest that migraine equivalents should not be considered merely as headache precursors, but they are part of the migrainous syndrome. Thus, their inclusion among the diagnostic criteria for pediatric migraine/tension-type headache is hopeful.Pediatric Neurology 11/2014; 51(5). DOI:10.1016/j.pediatrneurol.2014.07.018 · 1.50 Impact Factor