Vomiting and migraine‐related clinical parameters in pediatric migraine

Eidlitz‐Markus, Tal; Haimi-Cohen, Yishai; Zeharia, Avraham

doi:10.1111/head.13109

Cited by 12 publications

(6 citation statements)

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“…In contrast to the relative stability of sensory hypersensitivities there was a distinct age and sex interaction in the proportion of migraineurs reporting vomiting and nausea driven by younger boys and, to a lesser degree, children overall. While this age-and sex-related difference has been previously reported (8,37) the physiology underlying the propensity of these specific symptoms in younger migraineurs remains unknown. Interestingly, a similar pattern is observed in motion sickness where the highest susceptibility is among children aged less than 12 years (38).…”

Section: Associated Symptoms In Paediatric Migrainementioning

confidence: 72%

Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study

et al. 2017

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Introduction Although migraine is a common headache complaint in children and adolescents there remains a significant gap in understanding the unique aspects of the disease in these age groups and their evolution with development. The aim of this retrospective cohort study was to identify migraine features that are influenced by age and sex. Methods The headache characteristics of 359 paediatric patients with a clinical diagnosis of migraine from a tertiary paediatric headache clinic were assessed. Patients retrospectively reported headache characteristics during a structured intake interview and clinical exam. Headache characteristics, description and associated symptoms were compared between children (age ≤ 12 years) and adolescents (age > 12 years), and between male and female migraineurs. Results Several migraine features differed significantly with age and/or sex, including: (i) a marked change from a 1:1 sex ratio in children to a 2:1 predominance of girls in adolescents; (ii) a higher frequency of headache attacks per month in adolescents and female migraineurs; (iii) a higher proportion of adolescents endorsed a 'throbbing' pain quality; (iv) a higher proportion of children reporting nausea and vomiting; and (v) a higher proportion of adolescents, particularly female migraineurs, had a diagnosis of a co-morbid anxiety. Conclusion The presentation of migraine, both in terms of its headache characteristics and associated symptoms, appear to vary as a function of age and sex. Given that migraine symptoms have a neural basis, it is not surprising that during the key period of neurodevelopment from childhood to adolescence this may impact their presentation.

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Section: Associated Symptoms In Paediatric Migrainementioning

confidence: 72%

Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study

et al. 2017

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“…Vomiting in our pediatric cohort was observed at significantly higher rates in males than females, contrary to studies in adults [ 24 ]. Since the males in our study were younger than the females, we assume their relatively worse autonomic dysfunction contributed to this difference [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Symptoms and clinical parameters of pediatric and adolescent migraine, by gender - a retrospective cohort study

Eidlitz‐Markus

Zeharia

2017

J Headache Pain

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BackgroundThe available data on gender differences in clinical migraine parameters among pediatric patients are based on relatively few studies, which did not use the current version of the International Classification of Headache Disorders (ICHD) of the International Headache Society. The aim of the present study was to compare between males and females, demographic and clinical characteristics of children and adolescents with migraines diagnosed according to the ICDIII-beta version.MethodsThe electronic database of a tertiary pediatric headache clinic was searched for all children and adolescents diagnosed with migraine headaches in 2010–2016. Data on demographics, symptoms, and headache-related parameters were collected from the medical files. Findings were compared by gender.ResultsThe cohort included 468 children and adolescents of mean age 11.3 ± 3.6 years; 215 males (45.9%) and 253 females (54.1%). Migraine without aura was documented in 313 patients (66.9%), and migraine with aura in 127 (27.1%); 28 patients (6.0%) had probable migraines. The female patients had significantly higher values than the male patients for the following parameters: age at admission (p = 0.042, Cohen’s d 0.8303, 95% CI 0.614–0.992); age at migraine onset (p = 0.021, Cohen’s d 0.211, 95% CI 0.029–0.394); rate of migraine with aura (OR 2.01, 95% CI 1.29–3.16, p = 0.0056); headache frequency (p = 0.0149, Cohen’s d 0.211, 95% CI 0.029–0.3940); rate of chronic migraine (p = 0.036, OR 1.54, 95% CI 1.02–2.34); and puberty (OR 3.51, 95% CI 2.01–6.35, p = <0.001). Males had a higher rate of vomiting (OR 0.62, 95% CI 0.41–0.93, p = 0.018). Further analysis by pubertal stage revealed that pubertal females, but not prepubertal females, had a significantly higher rate of migraine with aura than did males (41.1% versus 28.9%; OR 1.42, 95% CI 0.85–2.37, p = 0.039).ConclusionFemale children and adolescents with migraine treated in a tertiary pediatric headache clinic were characterized by a higher rate of chronic migraine and migraine with aura, a lower rate of vomiting, and older age at onset relative to males. These findings might be influenced by the better description of migraine symptoms by females owing to their better verbal ability.

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“…CGRP and serotonin involved in the modulation of cortical spreading depression, cortical pain transmission and intestinal microbiota [50] hyperactivation of the parasympathetic and sympathetic nervous systems and alterations of adrenergic autonomic system [51] Abdominal migraine mitochondrial disease gene mutations and hypothalamic-pituitary-axis dysfunction [33] Infantile colic hypersensitivity influenced by circadian biology and CGRP modulates the sensory activity that, on its turn, is potentially involved in the pathogenesis of abdominal pain by inducing the neurogenic inflammation of sensory neurons in the gut [50] Benign paroxysmal vertigo defective neuronal channel activity [28] Benign paroxysmal torticollis mutation of calcium ion, sodium/potassium pump and sodium transporter (CACNA1A, ATP1A2 and SCN1A) [66][67][68][69][70] Motion sickness vestibular instability due to a defective calcium ion channel, involvement of vomiting center [77] Recurrent limb pains are recurrent short episodes of pain lasting until 72 h leading to an interruption of activities. Pain is localized deeply in the extremities of arms or legs.…”

Section: Cyclic Vomiting Syndromementioning

confidence: 99%

“…The currently proposed models include different mechanisms, such as alteration of autonomic system [39], metabolism disorders including mitochondrial and fatty acid suggested by the high rates of maternal genetic transmission [40][41][42], gastric dysmotility [43][44][45][46][47], an altered release at the hypothalamicpituitary level of factors, such as corticotropin and release of vasopressin [33], endocannabinoid system dysfunction [38,48,49] and neuronal hyperexcitability [38]. Migraine and CVS share co-involvement of calcitonin gene-related peptide (CGRP) and serotonin in the modulation of cortical spreading depression, cortical pain transmission and intestinal microbiota [50], hyperactivation of the parasympathetic and sympathetic nervous systems and alterations of adrenergic autonomic system, both in children and adults [51]. Vomiting involves area postrema in the central nervous system and peripheral nervous system such as vagal and non-vagal pathways, and the gastrointestinal tract.…”

Section: Introductionmentioning

confidence: 99%

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Migraine and Its Equivalents: What Do They Share? A Narrative Review on Common Pathophysiological Patterns

Frattale

Ruscitto

Papetti

et al. 2021

Life

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Migraine is the first in order of frequency of the neurological disorders, affecting both adult and paediatric populations. It is also the first cause of primary headaches in children. Migraine equivalents are periodic disorders that can be associated with migraine or considered as prognostic features of a future migraine manifestation. Despite the mechanisms underlying migraine and its equivalents are not entirely clear, several elements support the hypothesis of common pathophysiological patterns shared by these conditions. The aim of this review is thus to analyze the literature in order to highlight which currently known mechanisms may be common between migraine and its equivalents.

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Vomiting and migraine‐related clinical parameters in pediatric migraine

Cited by 12 publications

References 32 publications

Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study

Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study

Symptoms and clinical parameters of pediatric and adolescent migraine, by gender - a retrospective cohort study

Migraine and Its Equivalents: What Do They Share? A Narrative Review on Common Pathophysiological Patterns

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