title: Early Diagnosis of Migraine Necessary in Children: 10-Year Follow-Up.
abstract: BACKGROUND
  The prevalence of migraine in individuals younger than 20 years old is 8%, with a mean age at onset of younger than 8 years. However, the long-term prognosis of migraine attacks has not been clearly established.
  
  
  OBJECTIVE
  Our main objective was to evaluate disease course 10 years after migraine diagnosis in a cohort of children and adolescents.
  
  
  METHODS
  Migraine was diagnosed in 1999 in a pediatric headache reference center using International Headache Society criteria. In 2009, all patients were interviewed by telephone on the persistence and characteristics of any headaches. The main end point was prevalence of persistent migraine attacks in 2009. Variables associated with persistent attacks were analyzed.
  
  
  RESULTS
  Overall, 142 children were diagnosed with migraine in 1999. Of these, 84 were interviewed by telephone in 2009. In 1999, the mean age was 11.6 ± 3.1 years, 54% were male, and 50% had migraine without aura. Migraine attacks were common (1-3 attacks/week in 38%). Mean age at onset was 7 years and 4 months (±3 years). In 2009, migraine prevalence was 39/84 (46% [95% confidence interval 36-56]), 12 patients (14%) were headache-free, and 62 patients (74%) had tension-type headaches that were isolated headaches in 33 (39%) patients. The rate of patients with at least one migraine attack per week fell from 37% to 8% (P = 0.001) over the 10-year period. Age at the first visit to the center was significantly higher in 2009 migraine sufferers than nonsufferers (12.5 ± 3.0 versus 10.9 ± 3.1 years (P = 0.02)). In multivariate analysis, age ≥12 years at the time of first presentation was the only significant factor associated with long-term chronic migraine (odds ratio = 3.0 [1.1-8.0]).
  
  
  CONCLUSIONS
  Ten years after first presentation, 46% of patients had migraine but the frequency of attacks had diminished. The only factor associated with chronic migraine was age ≥12 years at first presentation.
authors.affiliation: AP-HP, Centre national de ressources de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France; AP-HP, Urgences-Samu 93, Hôpital Avicenne, Bobigny, France. Electronic address: miegiski@wanadoo.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Galinski
authors.affiliation: AP-HP, Centre national de ressources de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France.
authors.forename: Samira
authors.initials: S
authors.lastname: Sidhoum
authors.affiliation: AP-HP, Centre national de ressources de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cimerman
authors.affiliation: AP-HP, Centre national de ressources de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Perrin
authors.affiliation: AP-HP, Unité fonctionnelle de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Annequin
authors.affiliation: AP-HP, Unité fonctionnelle de lutte contre la douleur, Hôpital Armand Trousseau, Paris, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tourniaire
mesh_terms: D002648:Child; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D018781:Tension-Type Headache / Q000175:diagnosis / Q000453:epidemiology
keywords: evolution; migraine; pediatrics; risk factors