Migraine-Related Symptoms in Childhood
Palm Beach Headache Center, Premiere Research Institute, Palm Beach Neurology, Nova Southeastern University, 4631 N. Congress Avenue, Suite 200, West Palm Beach, FL, 33407, USA, .Current Pain and Headache Reports (Impact Factor: 2.26). 09/2013; 17(9):339. DOI: 10.1007/s11916-013-0339-6
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.
- "In prepubertal children, migraine occurs in 3–10% (Barnes, 2011) with no difference between boys and girls (Goldstein and Chen, 1982; Waters and O'Connor, 1971). In this age group, periodic symptoms such as benign paroxysmal torticollis, benign paroxysmal vertigo, abdominal migraine, and cyclic vomiting syndrome become more frequent (Arruda et al., 2010; Cuvellier and Lepine, 2010; Winner, 2013), potentially due to more mature brainstem effectors. In contrast, in post-pubertal children, the hypothalamus is thought to reset its hormonal (e.g., gonadotropin releasing hormone) and neural (e.g., autonomic) systems (Fig. 2), which in turn may make females more susceptible to migraine (Alstadhaug, 2009; Facchinetti et al., 2000). "
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.
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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.
Article: Childhood Migraine
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