Resumen

LEGUIZAMON, C; CANATA, M  y  RECALDE, L. Childhood migraine in a neuropediatric clinic. Pediatr. (Asunción) [online]. 2005, vol.32, n.2, pp.19-24. ISSN 1683-9803.

Introduction: Headaches make up approximately 20% of pediatric consults, cause anxiety to parents, interfere in the child´s daily activities and are a frequent cause of missed school days. Migraine is a vascular type of moderate to severe, chronic, recurrent headache with symptom-free intervals. It is typically triggered by environmental factors, with familial clustering and hereditary predisposition, and is slightly more frequent in male children but equals out at puberty. Diagnosis is clinical. Objective: To describe the demographic and clinical characteristics of childhood migraine. Materials and Methods: Retrospective, descriptive, observational transverse cut study. The medical records of 361 children complaining of headaches seen in the nueropediatric clinic of the HCIPS from July 2003 to July 2005 were reviewed. Criteria of the International Headache Society (IHS) were used for classification. Results: Of 361 patients with a chief complaint of headache seen from July 2003 to July 2005, 131 (36%) were migraine, 87 (24%) were tension headaches, 13 (4%) mixed headaches and 130 (36%) secondary headaches. Of those diagnosed as migraine, 26 were excluded because of incomplete data. The most frequent age group was 7 - 9 years with 36 of 105 patients (34). Median age was 10 years. Median age at initial symptoms was 5 years. Females were 55 patients (52%), males were 50 (48%). Most patients, 88 of the 105 (84%) were from urban areas, and only 17 (16%) were from rural areas. Common migraine ocurred in 86 of 105 patients (82%), classic migraine in 1 (0.95%), complicated migraine in 18 (18%), all of these latter were of the basilar type. Unilateral migraine ocurred in 37 patients (35%), bilateral in 23 (22%), not specified in 45 (43%). Pain was pulsatile in 90 patients (86%), indeterminate in 15 (14%). It was of moderate intensity in 13 (12%), severe in 92 (88%). The most frequent associated symptoms were vomiting in 93 patients (89%) and nausea in 85 (81%). Most patients, 87%, had a family history. Neurological exam was normal in all patients. Conclusions: Migraine was the most frequent type of headache in female school age children in Asuncion and the metropolitan area. The most frequent accompanying symptom was vomiting. The intensity of the headache interrupts the child´s daily activities. Many patients had a family history. Neurological exam was normal in all patients.

Palabras clave : headache; migraine with aura; migraine without aura; children.