Children migraine syndrome--definition and classification through the time

Abstract

INTRODUCTION: Even today, the migraine syndrome is not completeley defined knowing that it does not have either clear laboratory correlate or objectively defining marker. There is a great number of differential diagnostic references to define and classify migraine headaches; from Galen to ICHD-II (International Classification of Headache Disorders); from September 2003. Migraine syndrome represents a current problem of both paediatrics and children's neurology. The aim of this paper is to understand and define the migraine syndrome among children through the history of medical science, in order to enable the interpretation of the most acceptable defining and classification criteria of the children's migraine syndrome. DEFINITION AND CLASSIFICATION: Sensory, vegetative and affective phenomena of migraine, recognizable only among people, with striking quantitative and qualitative variations depending on the patient, define the migraine syndrome of children in general. There are no completely reliable principles or guidelines which would enable the accurate, precise and quick diagnosis, or differential diagnosis of children's migraine syndrome. Vahlquist is the first one to give special criteria to diagnose children's headache. His criteria were invalid because of insisting on headaches being unilateral. Classification criteria for migraine in children were given by Bille in 1962, Prensky in 1976, Deubner in 1977, Congdon and Forsythe in 1979, Tomasi in 1980, Sillanappa in 1982, Kurtz and Barlow in 1984, Hockaday in 1988. IHS classification was brought by consensus in 1988, and it was last modified in September 2003, when a consensus was reached about applying the ICHD-II International Classification of Headache Disorders. CONCLUSION: Being insufficiently defined and incompletely etiologically, clinically and therapeutically clear, children's migraine syndrome represents a striking example of interdisciplinary, scientific, health, practical and clinical entity. The degree of interest in children's migraine syndrome is directly dependent on the level of social and health standards within the society.