The criteria in the beta version of the International Classification of Headache Disorders 3rd edition are useful for diagnosis of children with migraine aura, even though the visual symptoms of children with migraine aura tend to vary widely in colors, mode of onset, location, mobility, pattern and duration, as is allowing child and adolescent patients with migraine to illustrate their visual symptoms, according to a study published in Cephalalgia.
This hospital-based, observational, qualitative study examined the characteristics of the visual symptoms of 1079 children with migraine from May 2012 to May 2017. It was the first study to conduct an in-depth examination of the characteristics of migraine visual aura as experienced by adolescents and children.
For inclusion in the study, the children had to be between 6 and 17, have suffered at least 2 migraine attacks with visual symptoms, and be neurologically normal otherwise. Information about visual symptoms was obtained by developing a focused headache history for each patient, asking set questions about migraine attacks, and evaluating pictures drawn by the children to depict their symptoms.
Most participants analyzed for the study (76%) experienced visual symptoms that developed slowly over at least 5 minutes, and 69% experienced a symptom duration of less than 5 minutes.
The additional characteristics of these visual symptoms varied widely, but study investigators were able to conclude that visual symptoms during migraine attacks with no other identifiable cause, and which resolve fully with a full recovery of vision can be considered migraine visual aura no matter the duration, mobility, color, location, and pattern of those symptoms. Researchers also concluded, “[allowing] children to illustrate their visual symptoms may add valuable contribution to the consultation by providing additional information that they may not be able to articulate verbally.”
Ahmed M, Boyd C, Vavilikolanu R, Rafique B. Visual symptoms and childhood migraine: qualitative analysis of duration, location, spread, mobility, colour and pattern [published online April 8, 2018]. Cephalalgia. doi: 10.1177/0333102418766872