Migraine, a poorly understood pathology in childhood

Although migraine is the main chronic headache in childhood and adolescence , it remains extensively misdiagnosed. Schematically, migraine is a severe headache evolving by stereotyped attacks frequently associated with marked digestive symptoms (nausea, vomiting, abdominal pain). Throbbing pain, sens itivity to sound, and light land sometimes odors) are frequent additional s ymptoms. The attack is sometimes preceded by a visual or sensory aura. Rest brings relief, and sleep often ends the attack. Childhood migraine prevale nce varies between 5 and 10%. Migraine episodes are frequently triggered by several factors: emotional stress (school pressure, vexation, excitement, upset), hypoglycemia, lack or excess of sleep (weekend migraine), sensory s timulation (loud noise, bright light, strong odor, heat or cold, etc.), sym pathetic stimulation (sport, physical exercise). Attack treatments must be given at an early stage, oral ibuprofen (10 mg/kg) being particularly recom mended. If the oral route is not available because of nausea or vomiting, r ectal or nasal routes have then to be used. Nonpharmacological treatments ( biofeedback and interventions combining progressive muscle relaxation) have demonstrated good efficacy as prophylactic measures. Daily prophylactic ph armacological treatments are prescribed as the second line after failure of non-pharmacological treatments. (C) 2000 Editions scientifiques et medical es Elsevier SAS.