Clinical and demographic characteristics of migraine in urban children

Objective.-To establish the frequency, symptoms, duration, and treatment methods of childhood migraine in an urban area. Design.-Self-administered questionnaire survey. The questionnaire was designed according to criteria suggested by the International Headache Society (IHS). Participants.-In 1994, with the help of school officials in 41 elementary and middle schools in the Greater Cleve-lend Area, 18 000 questionnaires were distributed to the parents of schoolchildren who ranged in age from 5 to 13 years. Results.-Of the total 2572 respondents, 222 children (8.8%) met the IHS criteria for migraine. Male to female ratio was 1:1.2 (99:120), 65.8% had a positive family history of migraine, 30.6% had onset of migraine at 4 to 5 years of age, and 54.1% reported having an aura (71% of these were visual aura). The headaches were mostly pulsating, poorly localized, lasted about 2 to 12 hours, and were aggravated by motion, noise, and bright light. The associated symptoms were nausea, vomiting, photophobia, and phonophobia. During the attack, 43% of the migraineurs had to stay in bed, and 27% were unable to attend school. Only 19.8% of the migraineurs were diagnosed to have migraine by their physicians, and most of these had not received treatment. Conclusion.-This study in an urban area indicates that childhood migraine is a common, often underdiagnosed disorder that causes significant suffering for children and their families.