The Effects of Family History on the Diagnosis of Childhood Migraine / 대한소아신경학회지

ABSTRACT

PURPOSE: Headache is a common problem in children and adolescents, and they experience severe pain and disabilities from headache. But there had not been an appropriate system for the diagnosis and the classification for headache in children and adolescents before the international classification of headache disorders(ICHD-II) was developed. But family history was not included in this classification's criteria. So we evaluated the effects of family history on the diagnosis of children with recurrent headaches. METHODS: 217 patients with recurrent headaches younger than fifteen years old were selected. To diagnose the patients' headache, we utilized headache questionnaires, headache diaries, and studied the family history of headache on the patients' maternal and paternal lines. Final diagnosis was based on the ICHD-II. RESULTS: In the migrainous patients, 78.1% had positive family history of headache on the maternal lines, and 16.2% on the paternal lines. In the patients with tension-type headache, 56.8% had positive family history of headache on the maternal lines. When the mother of a patient suffered from recurrent headaches, migraine occurred 2.94 times as frequently as tension-type headache(Mantel-Haenszel odds ratio, 2.94; P<0.01; 95% confidence interval, 1.36-6.38). And if a patient had parents with recurrent headaches, migraine occurred 3.22 times as frequently as tension-type headache(odds ratio, 3.22; P<0.005; 95% confidence interval, 1.48-7.02). CONCLUSION: We can consider migraine rather than tension-type headache when a patient has family history of recurrent headaches. In our study, we were able to validate that positive family history of headache was important in diagnosing the headache of children.