title: Migraine equivalents as part of migraine syndrome in childhood.
abstract: BACKGROUND
  Migraine equivalents are common clinical conditions without a headache component, occurring as repeated episodes 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 prevalence of migraine equivalents in a large population of children referred to a pediatric headache center and to analyze the possible relationship between migraine equivalents and headache features.
  
  
  METHODS
  A total of 1134 of children/adolescents (73.2% with migraine and 26.8% with tension-type headache) were included. Patients were divided into two groups according to the episode frequency (high and low). Pain intensity was rated on a three-level 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. Although headache type (migraine or tension-type headache) did not correlate with migraine equivalents presence (χ(2) = 33.2; P = 0.27), high frequency of headache episodes correlated with the occurrence of migraine equivalents. Moreover, migraine equivalents indicated a protective role for some accompanying feature of the headache episode.
  
  
  CONCLUSIONS
  Our results suggest that migraine equivalents should not be considered merely as headache precursors, but they as part of the migrainous syndrome. Thus, their inclusion among the diagnostic criteria for pediatric migraine/tension-type headache is useful.
authors.affiliation: Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy. Electronic address: samuela.tarantino@gmail.com.
authors.forename: Samuela
authors.initials: S
authors.lastname: Tarantino
authors.affiliation: Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capuano
authors.affiliation: Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Torriero
authors.affiliation: Division of Psychology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Citti
authors.affiliation: Institute of Neurology, Universitá Cattolica, Rome, Italy.
authors.forename: Catello
authors.initials: C
authors.lastname: Vollono
authors.affiliation: Division of Psychology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Gentile
authors.affiliation: Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Vigevano
authors.affiliation: Headache Centre, Division of Neurology, Ospedale Pediatrico Bambino Gesú, Istituto di ricovero e cura a carattere scientifico, Rome, Italy; Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Valeriani
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D018781:Tension-Type Headache / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*
keywords: abdominal migraine; childhood headache; childhood periodic syndromes; limb pain; migraine equivalents; motion sickness