Persistent Asthma May Increase Migraine Risk in Children

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Treatment with antiasthma and antihistamine medication may help reduce migraine in this population.
Treatment with antiasthma and antihistamine medication may help reduce migraine in this population.

Children with persistent asthma are at increased risk for migraine, and treatment with antiasthma or antiallergy treatment may lower this risk, according to a study published in Headache.

Up to 1 in 5 children suffer from migraine, and the risk for migraine increases from childhood to adolescence. Migraine has been linked to atopic conditions, such as asthma and allergic rhinitis, in adults, and limited data suggest migraine may be associated with asthma in children.

In the current study, the researchers evaluated the relationship between atopic disease and migraine risk, as well as the effect of antiallergy treatment on migraine occurrence in children presenting to the emergency department with migraine.

A total of 229 children (6-18 years old) presenting with an episode of migraine and 406 age-matched control participants were enrolled.

Children with persistent asthma were more than 4 times as likely to have migraine as children without asthma (odds ratio [OR], 4.57). The degree of migraine risk with asthma was similar to the risk for migraine with aura and migraine without aura.

Persistent asthma was also associated with a higher frequency of migraines (3 migraines per month) than both intermittent asthma and no asthma (2 migraines per month for both groups; P <.01).

Compared with children without migraine, children with migraine were less likely to have been treated with at least 6 months of antihistamine therapy (OR, 0.33) or inhaled or nasal corticosteroids (OR, 0.34). These associations were similar for migraine with aura and migraine without aura.

The researchers noted that this was the first study to show that persistent asthma may increase migraine risk and that this risk may be mitigated with corticosteroid or antihistamine treatment. However, they acknowledged that further investigation is required. "Association between asthma and migraine has to be confirmed by supplemental studies such as case control studies comparing prevalence of migraine in subjects with or without asthma," they wrote. "Additional longitudinal studies in young children are required to discriminate between a hypothesis of a preventive role of anti-allergic therapies in the occurrence of migraine, by acting on inflammatory mediators released by mast cells during the allergic response, and a hypothesis of negative association between allergic rhinitis and migraine."

Reference

Aupiais C, Wanin S, Romanello S, et al. Association between migraine and atopic diseases in childhood: a potential protective role of anti-allergic drugs [published online February 4, 2017]. Headache. doi: 10.1111/head.13032

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