DIAGNOSES AND SYMPTOM PATTERNS IN CHILDREN PRESENTING TO A PEDIATRIC HEADACHE CLINIC

The diagnosis of migraine headache in children and adolescents is comp lex and not well understood. This study was conducted to compare diagn ostic rates, using various criteria for pediatric migraine, and specif ic symptom characteristics in a sample of children referred for care t o a specialized pediatric headache clinic. A structured interview was used at the patient's initial assessment visit to elicit symptom patte rns and therapies attempted for headache. Clinical diagnoses were base d on consensus agreement reached by a multidisciplinary team. Statisti cally derived diagnostic rates based on International Headache Society (IHS), Prensky, Vahlquist and our own criteria were significantly low er than clinical diagnostic rates. IHS diagnostic rates were different ially distributed as a function of race, but no other effects were fou nd for demographic variables on diagnostic rates. Specific symptom pat terns, however, varied as a function of race, gender and age of the ch ild. The results underscore the need for comprehensive, developmentall y based models of the evolution of migraine headache as a foundation f or future research and the further development of clinically sensitive diagnostic criteria for pediatric migraine.