Brief migraine episodes in children and adolescents-a modification to International Headache Society pediatric migraine (without aura) diagnostic criteria

This paper reports the results of a systematic assessment of the validity of the specific diagnostic criteria for migraine without aura, as defined by the International Headache Society (IHS), in a longitudinal epidemiologic sample of young adults who were selected from the general population of Zürich, Switzerland. Systematic modification of each of the IHS criteria for migraine without aura yielded one-year weighted prevalence rates ranging from 24% for the unmodified IHS criteria to 9% for the most restrictive definition of migraine. The major implications of the findings for the IHS criteria are: (a) they provide adequate coverage to classify the majority of subjects with headache in the general population; (b) there is little overlap between migraine and tension-type headache, suggesting that the criteria define moderately independent subgroups; (c) the criteria for migraine without aura appear to be too unrestrictive for application in the community, particularly among young adults at the peak period of incidence of migraine; (d) the criteria for “aura” need more precise operationalization; and (e) models of validation of the diagnostic criteria suggest that Criterion D of the IHS criteria for migraine without aura should be modified to require both gastrointestinal symptoms and photophobia and phonophobia.

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Assessment of International Headache Society Diagnostic Criteria: A Reliability Study

Cephalalgia ◽

10.1046/j.1468-2982.1994.1404280.x ◽

1994 ◽

Vol 14 (4) ◽

pp. 280-284 ◽

Cited By ~ 45

Author(s):

M Leone ◽

G Filippini ◽

D D'Amico ◽

M Farinotti ◽

G Bussone

Keyword(s):

Diagnostic Criteria ◽

Medical Records ◽

Migraine Without Aura ◽

International Headache Society ◽

Tension Type Headache ◽

Kappa Statistics ◽

Reliability Study ◽

Ihs Criteria ◽

Craniofacial Pain ◽

Type Headache

In 1988 the International Headache Society (IHS) introduced new diagnostic criteria for headaches and craniofacial pain. Since headaches can be diagnosed solely on the basis of information provided by the patient, it is essential that the criteria are reproducible and consistent. phenomena to a form designed to reflect the IHS criteria. Interobserver concordance (kappa statistics) in the application of the diagnostic hemicrania; kappa = 0.88 for migraine; kappa = 0.75 for tension-type headache; (ii) “almost perfect” to “substantial” for the second digit migraine without aura; kappa = 0.71 for chronic tension-type headache; kappa = 0.66 for cluster headache-like disorder not fulfilling the eria. These results show that the IHS diagnostic criteria are satisfactorily applicable to high quality medical records abstracted by experienced.

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Migraine with aura: A predictor of patent foramen ovale in children and adolescents

Cephalalgia ◽

10.1177/0333102413477740 ◽

2013 ◽

Vol 33 (7) ◽

pp. 463-468 ◽

Cited By ~ 12

Author(s):

Deok Young Choi ◽

Dong Hoon Shin ◽

Kang Ho Cho ◽

Sang Pyo Lee ◽

Sanghui Park

Keyword(s):

Children And Adolescents ◽

Normal Control ◽

Migraine With Aura ◽

Patent Foramen Ovale ◽

Migraine Without Aura ◽

Statistical Significance ◽

Control Group ◽

Foramen Ovale ◽

Children And Adolescent ◽

Pediatric Migraine

Background The prevalence of patent foramen ovale (PFO) is higher among adult migraine patients. The purpose of this study was to determine the frequency of PFO in children and adolescent migraine patients. Methods and results A total of 32 patients with migraine (divided into two subgroups, the migraine with aura subgroup and the migraine without aura subgroup) and 31 normal control subjects were enrolled in this study. All of the participants underwent transthoracic echocardiography with an agitated saline test. We compared the prevalence of PFO and the severity of right-to-left shunt (RLS) in each group. No statistical difference in age and sex ratio was observed in either group. The prevalence of PFO was higher in the migraine group than in the control group, but without statistical significance (46.9% vs. 25.8%, p = 0.084). The prevalence of PFO was significantly higher in the migraine with aura subgroup than in the migraine without aura subgroup ( p = 0.031) and the normal control group ( p = 0.0074). Migraine with aura was the only significant factor showing an association with PFO (<0.01). RLS size did not have an influence on migraine. Conclusions Considering the significantly high prevalence of PFO in pediatric migraine with aura patients, migraine with aura is a clear predictor of PFO among children and adolescents.

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Short Migraine Attacks of less than 2 h Duration in Children and Adolescents

Cephalalgia ◽

10.1111/j.1468-2982.2004.00670.x ◽

2004 ◽

Vol 24 (5) ◽

pp. 333-338 ◽

Cited By ~ 20

Author(s):

I Abu-Arafeh ◽

M Callaghan

Keyword(s):

Children And Adolescents ◽

Diagnostic Criteria ◽

International Headache Society ◽

Ihs Criteria ◽

Headache Clinic

We studied the duration of migraine attacks among children and adolescents who reported headache attacks lasting <2 h. Among the 720 children who attended our specialist headache clinic, over a period of 6 years, 231 children had migraine with or without aura fulfilling the International Headache Society (IHS) criteria for the diagnosis of migraine. A further 15 children reported headache attacks typical of migraine, but of duration <2 h. They were asked to fill prospective headache diaries in order to determine with accuracy the duration of their headache attacks. Ten (67%) of these children provided prospective fully analysable headache diaries and recorded a total of 120 headache attacks, 66 attacks (55%) lasting for <1 h each, 30 attacks (25%) lasting between 1 and 2 h, and 24 attacks (20%) lasting >2 h. Patient-based analysis of the headache diaries showed that only three children consistently had headache attacks lasting <1 h. Seven children had some of their headache attacks lasting for at least 1 h and four had some of their headache attacks lasting at least 2 h. This study shows that headache attacks in children with migraine can be variable, and brief attacks are rare. A combination of short (<1 h) and long (>2 h) attacks of headache can coexist in the same patient. The HIS diagnostic criteria of 1988 for migraine in children should therefore acknowledge such variation and allow reduction of the duration of migraine attacks to 1 h.

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Migrainous disorder and headache of the tension-type not fulfilling the criteria: a follow-up study in children and adolescents

Cephalalgia ◽

10.1111/j.1468-2982.2000.00090.x ◽

2000 ◽

Vol 20 (7) ◽

pp. 611-616 ◽

Cited By ~ 29

Author(s):

K Zebenholzer ◽

C Wöber ◽

C Kienbacher ◽

Ç Wöber-Bingöl

Keyword(s):

Children And Adolescents ◽

Diagnostic Criteria ◽

Migraine Without Aura ◽

Tension Type Headache ◽

Follow Up Study ◽

Ihs Criteria ◽

Type Headache

In this follow-up study in children and adolescents with recurrent headaches classified as migrainous disorder (IHS 1.7) and headache of the tension-type not fulfilling the criteria (IHS 2.3), 28.6% were headache-free and 71.4% still had headaches 2-5 years after the first examination. The majority remained in the same one-digit IHS diagnosis, whereas 20% changed from migraine to tension-type headache or vice versa. The number of IHS criteria fulfilled increased significantly from the first to the second examination. The reason for diagnosing IHS 1.7 and IHS 2.3 most often was a short headache duration or headache characteristics not meeting the criteria. By reducing the minimum headache duration to 1 h, 11 of 58 patients could be diagnosed as migraine without aura. There was a remarkable overlap in the diagnostic criteria for migraine without aura and tension-type headache. In IHS 1.7 and IHS 2.3 this overlap exceeded 80%, with a trend to decrease at the second examination.

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Abnormal Perceptual Experiences in Migraine

Cephalalgia ◽

10.1046/j.1468-2982.1990.1006273.x ◽

1990 ◽

Vol 10 (6) ◽

pp. 273-277 ◽

Cited By ~ 24

Author(s):

Diana P Morrison

Keyword(s):

Body Image ◽

Electrical Activity ◽

Diagnostic Criteria ◽

Limbic System ◽

Migraine Without Aura ◽

Spreading Depression ◽

International Headache Society ◽

Consecutive Series ◽

Mood Change ◽

Cortical Electrical Activity

The prevalence of abnormal perceptual experiences as symptoms of migraine attacks was determined in a consecutive series of 46 new female referrals to a migraine clinic. All patients met the diagnostic criteria of the International Headache Society for migraine with aura or migraine without aura and had no other serious physical illness. Seven patients (15%) reported abnormal perceptions (olfactory and/or gustatory hallucinations and distortions of body image) as part of most migraine attacks. A statistically significant association was found between these abnormal perceptual experiences and complaints of mood change, particularly increased depression and irritability, as part of most migraine attacks. It is suggested that spreading depression of cortical electrical activity may be responsible for the manifestations of temporal lobe and limbic system dysfunction.

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Migraine without aura and migrainous disorder in children; International Headache Society (IHS) and revised IHS criteria

Cephalalgia ◽

10.1046/j.1468-2982.2000.00103.x ◽

2000 ◽

Vol 20 (7) ◽

pp. 617-620 ◽

Cited By ~ 8

Author(s):

A Cano ◽

E Palomeras ◽

S Alfonso ◽

D Ortega ◽

P Sanz ◽

...

Keyword(s):

Migraine Without Aura ◽

International Headache Society ◽

Ihs Criteria

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Abstract P088: Obesity, Hypertension and Insulin Resistance in a Primary Pediatric Setting in Southern Italy

Circulation ◽

10.1161/circ.129.suppl_1.p088 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Giampaolo De Filippo ◽

Domenico Rendina ◽

Domenico Viggiano ◽

Antonio Fasolino ◽

Paola Sabatini ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Weight ◽

Children And Adolescents ◽

Diagnostic Criteria ◽

Southern Italy ◽

Serum Insulin ◽

High Density Lipoproteins ◽

Obese Children ◽

Campania Region

Background: Obesity is the main risk factor for essential hypertension (EH) in childhood. The O.Si.Me. study (Obesity and Metabolic Syndrome in children and adolescents) evaluated the prevalence of metabolic syndrome (MetS) and its constitutive traits in a sample of obese children and adolescents living in Campania, southern Italy. Patients and methods: Four hundred and fifteen children and adolescents consecutively referred to the National Health Service participating Outpatient Clinics for minor health problems and found to have a Body Mass Index (BMI) Z-score > 2.0 were enrolled in the study. The entire sample was screened for MetS, which was defined as the presence of at least 2 of the following alterations in addition to obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and EH. The present analysis evaluated the clinical characteristics of the O.Si.Me subgroup of EH participants (systolic and/or diastolic BP ≥ 95 th percentile for age, gender and height) as compared with normotensive participants. Results: The prevalence of EH in the O.Si.Me population was 23.6 % (98/415, 48M and 50F.) and two-thirds of the EH participants met the MetS diagnostic criteria. The EH participants featured serum insulin and HOMA-IR levels significantly higher compared with normotensive ones (11.6±0.6 vs. 9.5±0.4 μIU/ml, p = 0.014; 2.6±0.1 vs. 2.2±0.1, p = 0.028 for insulin and HOMA-IR, respectively). These differences were common to boys and girls and remained significant after correction for age, pubertal stage, body weight, length, BMI, gestational age at birth, duration of breastfeeding and anthropometric parental parameters. Accordingly, children and adolescents with EH had a a relative risk of being insulin resistant (defined as a HOMA-IR ≥2.5) significantly greater compared to those without. Moreover, they exhibited higher serum creatinine levels (53.8±7.1 vs. 35.4±6.8 μmol/l, p=0.025) accounting for gender and body weight. Conclusions: More than a quarter of obese children and adolescents meet the diagnostic criteria for EH in the Campania region in southern Italy. These obese boys and girls have an increased prevalence of insulin resistance and apparently an initial reduction in renal function compared with obese children and adolescents with normal BP.

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