Visual symptoms and childhood migraine: Qualitative analysis of duration, location, spread, mobility, colour and pattern

Cephalalgia ◽  
2018 ◽  
Vol 38 (14) ◽  
pp. 2017-2025
Author(s):  
Mas Ahmed ◽  
Catriona Boyd ◽  
Radhika Vavilikolanu ◽  
Bushra Rafique
Keyword(s):  
Qualitative Analysis ◽  
Children And Adolescents ◽  
Visual Fields ◽  
International Classification ◽  
Headache Disorders ◽  
Visual Aura ◽  
Visual Symptoms ◽  
Research And Innovation ◽  
Beta Version

Aim To examine the characteristics of visual symptoms during attacks of migraine in children and adolescents. Method A qualitative analysis of prospectively collected data over 5 years, on characteristics of visual symptoms during migraine attacks. Diagnosis of migraine and aura was based on the International Classification of Headache Disorders 3rd edition beta version. We also provided the opportunity for patients to illustrate their visual aura symptoms to aid in diagnosis. Results Visual symptoms were reported by 387/1079 (36%) of migraineurs. Of these, 172 (16%) patients fulfilled the International Classification of Headache Disorders Criteria A, B, C iv and D, but missed one (n = 75; 43.5%) or two (n = 97; 56.5%) of the remaining items of criteria C as the visual symptoms were of non-gradual spread (n = 35; 20%), appeared in both visual fields (n = 99; 58%), or lasted less than 5 minutes or more than 60 minutes (n = 129; 75%). Conclusion The International Classification of Headache Disorders 3rd edition beta version criteria are useful in diagnosis of migraine with visual aura in children and adolescents, but visual symptoms varied considerably in duration, pattern, mobility, location, mode of onset and colours. Providing opportunity for patients to illustrate their symptoms can provide additional diagnostic information. The pathophysiology and the clinical concept of typical MVA is still to an extent an assumption and needs further evaluation. Approval The study was approved by the Health Research Authority – London and the local Research and Innovation Department at Barking Havering and Redbridge National Health Service Trust. Formal parental consent was not considered essential for this type of study.

Vestibular Migraine with Visual Aura and Olfactory Hallucination in Children: Two Case Reports

2018 ◽  
Vol 49 (06) ◽  
pp. 414-416 ◽  
Author(s):  
T.R. Villa ◽  
L.M. Agessi
Keyword(s):  
Case Reports ◽  
International Classification ◽  
Vestibular Migraine ◽  
Migraine Aura ◽  
Headache Disorders ◽  
Visual Aura ◽  
Clinical Description ◽  
Olfactory Hallucination

Background Approximately 3.9% children with migraine have olfactory hallucination which was defined as a perception of a smell without the substantial existence of any physical odor. Case We described the first two cases of children with vestibular migraine, presenting visual aura and olfactory hallucination. ​ We reported two children with vertigo, visual aura, and olfactory hallucination before the headache who were responsive to topiramate. Conclusion The clinical description of olfactory hallucination presented some characteristics of migraine aura. Olfactory hallucinations could be inserted as a migraine aura in International Classification of Headache Disorders.

Tolosa-Hunt Syndrome: Appraising the ICHD-3 beta diagnostic criteria

Cephalalgia ◽  
2017 ◽  
Vol 38 (10) ◽  
pp. 1696-1700 ◽  
Author(s):  
Evan Mullen ◽  
Mark Green ◽  
Eliza Hersh ◽  
Alfred-Marc Iloreta ◽  
Joshua Bederson ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
False Negative ◽  
Granulomatous Inflammation ◽  
International Classification ◽  
Headache Disorders ◽  
Hunt Syndrome ◽  
Cranial Nerve Palsies ◽  
Beta Version

Introduction The term Tolosa-Hunt Syndrome was first used more than half a century ago to describe painful ophthalmoplegia accompanied by cranial nerve palsies. In the decades since, its diagnostic criteria have evolved considerably. The beta version of the 3rd Edition of the International Classification of Headache Disorders narrows these criteria to require the demonstration of granulomatous inflammation on MRI or biopsy. We believe this may introduce challenges to accurate diagnosis. Discussion Requiring the demonstration of granulomatous inflammation for a diagnosis of Tolosa-Hunt Syndrome may introduce the potential for false negative and false positive diagnoses. Although the disorder presents secondary to granulomatous inflammation, MRI technology may not be able to identify it reliably, and biopsy is not always indicated for its symptomatology. Additionally, several cases have been reported of Tolosa-Hunt Syndrome diagnosed with MRI-confirmed granulomatous inflammation that later prove to be attributable to other pathologies. The emphasis on neuroimaging may therefore exclude some true Tolosa-Hunt Syndrome cases and include others resulting from other latent pathologies that are not visible on MRI. Conclusion We wish to offer several potential modifications to the International Classification of Headache Disorders guidelines for Tolosa-Hunt Syndrome, including making the demonstration of granulomatous inflammation on MRI or biopsy non-mandatory and lengthening patient follow-up to two years for cases in which MRI is unrevealing.

scholarly journals Comprehensive Application of the International Classification of Headache Disorders Third Edition, Beta Version

2016 ◽  
Vol 31 (1) ◽  
pp. 106 ◽  
Author(s):  
Byung-Kun Kim ◽  
Soo-Jin Cho ◽  
Byung-Su Kim ◽  
Jong-Hee Sohn ◽  
Soo-Kyoung Kim ◽  
...  
Keyword(s):  
International Classification ◽  
Headache Disorders ◽  
Beta Version

The Prevalence of Premonitory Symptoms in Paediatric Migraine: A Questionnaire Study in 103 Children and Adolescents

Cephalalgia ◽  
2009 ◽  
Vol 29 (11) ◽  
pp. 1197-1201 ◽  
Author(s):  
J-C Cuvellier ◽  
A Mars ◽  
L Vallée
Keyword(s):  
Children And Adolescents ◽  
International Classification ◽  
Questionnaire Study ◽  
Headache Disorders ◽  
Attack Frequency ◽  
Premonitory Symptom ◽  
The Mean ◽  
Premonitory Symptoms

The prevalence and characterization of premonitory symptoms have not been rigorously studied in children and adolescents. Using a questionnaire, we retrospectively studied the prevalence of 15 predefined premonitory symptoms in a clinic-based population. In 103 children and adolescents fulfilling the International Classification of Headache Disorders, 2nd edn criteria for paediatric migraine, at least one premonitory symptom was reported by 69 (67%). The most frequently reported premonitory symptoms were face changes, fatigue and irritability. The mean number of premonitory symptoms reported per subject was 1.8 (median 2.2). Age, migraine subtype (with or without aura) and mean attack frequency per month had no effect on the mean number of premonitory symptoms reported per subject. In conclusion, premonitory symptoms are frequently reported by children and adolescents with migraine. Face changes seem to be a premonitory symptom peculiar to paediatric migraine.

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