A 40-Year Follow-Up of School Children with Migraine

Abstract

A prevalence study of 9000 Swedish school children conducted in 1955 showed that nearly 4% had migraine. The prevalence of migraine was 1.4% at 7 years of age and 5.3% at 15 years of age. From the age of 11 there was a gradual increase of migraine headache and a predominance among girls. A subgroup of 73 children with pronounced migraine and an average onset of 6 years was followed during a period of 40 years. The results showed that 23% of the children were migraine-free before the age of 25, boys significantly more often than girls. However, around the age of 50, more than half of the migraine group still had migraine attacks. A recall bias was found in that a number of the subjects in their middle-life (41%) could not remember that they had had aura symptoms previously. Of those who had become parents, 52% have in their present or previous families had one child or more who had developed recurrent headache, probably of the migraine-type.

A population-based follow-up study of headache from age 7 to 22 years

“…In accordance with previous reports [8,12], headache in the present study occurred as often in girls as it did in boys at preschool age. The occurrence of headache disturbing everyday life in more than one-fourth of children aged 7 years might sound alarming.…”

“…from migraine in childhood were migraine-free by age 25 years, boys significantly more often than girls. However, around the age of 50 years, more than half of those with childhood migraine still had migraine attacks [8]. In their 8-year follow-up study, Guidetti and Galli [9] concluded that headache of juvenile onset changes its characteristics over time, and there is a high tendency of headache to remit (mostly in males) or to improve [9].…”

Headache in Children and Adolescents

“…This analysis showed that around 60% of children and adolescent are prone to headaches and 8% prone to migraines, over periods varying from 3 months to lifetime [18] .In another review, covering 64 cross-sectional epidemiological studies published in 32 different countries in past 25 years, the mean prevalence of headaches and migraines in children and adolescents was 54.4% and 9.1%, respectively [19] .The prevalence of a tension-type headache in children in population and school-based surveys estimated about 31% (10%-72%) [6] .The prevalence revealed an upward trend with increasing age for overall headache causes, migraine and TTH [17,[20][21]. There was a preponderance for female sex for overall headache causes (67% in females versus 58% in males) and migraine (9.7% in females versus 6% in males) [18,[20][21][22][23] . Long term trends show significant increase in incidence and prevalence of migraine and headache over the last 30 years, more so in developing countries, probably reflecting untoward changes in children"s lifestyle.…”

“…In long-term follow-up of childhood migraine, up to 1/3 rd of patients will experience remission [21,99] . Another 20-25% shift from migraine to TTH or vice versa [99] .…”

“…Diagnoses of primary headache subtypes change over time due to overlapping symptoms and possibly related to maturation [17] . Of those who had become parents, 52% have in their present or previous families had one child or more who had developed recurrent headache, probably of the migraine-type [21] . Risk factors that predict persistence and unfavourable clinical course include headache onset early in life, frequent headaches, increasing time between headache onset and first examination, female sex, maternal history of headache, comorbid psychiatric illness, poor sleep and stress, medication overuse, and poor self-efficacy for managing headaches [17, 21-22, 48, 52, 56, 99, 101-102] .…”