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Prognosis of childhood migraine

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Abstract

The long term prognosis of adolescents with migraine has not been well studied. Five to seven year follow up studies revealed that 20–25% of adolescents originally diagnosed with migraine have remission of symptoms, 50–60% have persistence of their migraine with aura and 25% converting to TTH. Of those originally with TTH, 20% converted to migraine [121,122]. Monastero et al. evaluated 55 adolescents with migraine who were available for ten year follow up and found that 42% had persistent migraine, 38% had experienced remission, and 20% had transformed to TTH. Interestingly, only migraine without aura persisted through the ten year follow up whereas other migrainous disorders and nonclassifiable headaches did not [123]. The longest follow up available came from Brna et al, with 20 year information on 60 out of an original cohort of 95 from 1983. Of the 60, 27% were headache free, 33% had TTH, 17% had migraine and 23% had both TTH and migraine. Of those with persistent headache, 80% described their headaches as moderate to severe, although an overall improvement was described in 66%. TTH was more likely to remit. Headache severity at diagnosis was the most predictive of headache outcome at 20 years [124]. These data indicate that female gender, migraine severity at diagnosis, and longer duration from time of onset of headache until time of initial medical examination tended toward unfavorable prognosis.

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Lewis, D.W. (2010). Prognosis of childhood migraine. In: Clinician’s Manual on Treatment of Pediatric Migraine. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-908517-20-3_6

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