Prognosis of childhood migraine

  • Donald W. Lewis


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.


Migraine With Aura Headache Severity Original Cohort Unfavorable Prognosis Migraine Without Aura 
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© Springer Healthcare, a part of Springer Science+Business Media 2010

Authors and Affiliations

  • Donald W. Lewis
    • 1
  1. 1.Department of Pediatrics Children’s Hospital of The King’s DaughtersEastern Virginia Medical SchoolNorfolkUSA

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