Many children and adolescents with migraines experience the same premonitory symptoms as adults who experience migraines, according to study results published in Pediatric Neurology.
Researchers collected and analyzed data on children and adolescents with episodic and chronic migraines treated at a multidisciplinary pediatric headache clinic over a 6-month period to evaluate the pediatric frequency of the following migraine premonitory symptoms most commonly reported by adults: fatigue, mood changes, neck stiffness, yawning, increased urination, and food cravings. Investigators took histories to determine headache frequency and any behavioral or psychological comorbidities that could be associated with these symptoms.
Among the total 176 patients (ages 4-18 [mean age 12] years; 64% girls) enrolled in the study, 42% (n=74) had ≥1 migraine premonitory symptom. Participants with migraine with aura had a significantly higher association with these symptoms (59%, n=30; P <.05), as did participants with anxiety disorder (55%, n=11; P <.05). The most commonly reported premonitory symptoms were mood changes (57% overall) and fatigue (68% overall). Researchers did not observe any significant differences in migraine premonitory symptoms by sex or age (<12 vs ≥12 years).
Study investigators concluded, “[Premonitory symptoms] were common in our pediatric patients with migraine. Fatigue and mood changes were the most commonly reported symptoms, similar to previous studies. Anxiety and migraine with aura were significantly associated with an increased likelihood of [premonitory symptoms] in our group of patients. Elicitation of these symptoms may improve management and lessen the effect of migraine headaches in children and adolescents.”
Jacobs H, Pakalnis A. Premonitory symptoms in episodic and chronic migraine from a pediatric headache clinic [published online March 29, 2019]. Pediatr Neurol. doi:10.1016/j.pediatrneurol.2019.03.023