Do both paternal and maternal smoking influence the prevalence of childhood asthma? A study into the prevalence of asthma in children and the effects of parental smoking.

Asthma is one of the commonest of chronic illnesses affecting children. Parental smoking has been considered to have an effect on this. In an attempt to clarify the relationship between parental smoking and the prevalence of childhood asthma we interviewed parents of 97.5% of the children aged 3-11 years registered with a large urban British general practice. We found a lifetime prevalence of asthma of 19.6%, 23.2% of boys and 15.9% of girls. Asthma was more common, 37.6%, in children who also had eczema. Parental smoking appeared to increase the prevalence of asthma. This was more marked when both parents smoked.

1044 women with migraine: the effect of environmental stimuli.

This study initiated by a self-help migraine group investigated disability caused by visual environmental stimuli, e.g. glare, flicker, pattern and color. One thousand forty-four women with migraine completed the self-report questionnaire on visual environmental stimuli reported in earlier studies to precipitate or aggravate migraine. One hundred twenty-one female controls were obtained from general practice and hospital out-patients. The responses of the classical, common and non-migraine groups were compared. Women with classical migraine expressed greater disability than those with common migraine or controls both in respect of number of visual sensitivities reported (P < 0.0001) and severity of consequences of such stimuli (P < 0.0001). This study indicated differences between classical and common migraine outside of the attack phase apart from aura. Reported range of sensitivities for the migraineurs peaked between the ages of 46-60 years. A high level of unrealized disability caused by visual environmental stimuli was thus identified in hitherto unexplored self-help groups.

The prevalence of childhood atopic eczema in a general population.

BACKGROUND: Atopic eczema has become more common during recent decades, but few studies have looked at its prevalence in the general community. OBJECTIVE: Our purpose was to ascertain the prevalence of atopic eczema, its age of onset, and its relationship to breast-feeding and ear piercing in a general practice population. METHODS: Children (N = 1104), aged 3 to 11 years, were identified from a computerized register in a socially and ethnically mixed English general practice population of 13,314. Of these, 1077 children (97.6% recruitment) were interviewed with parents or guardians, and the resultant data were recorded on a survey form. RESULTS: The lifetime occurrence of atopic eczema was 20% in boys (12% in the past year) and 19% in girls (11% in the past year). Prevalence in the past year was 10% to 14% in boys aged 3 to 11 years but fell in girls from 15% at 3 to 5 years to 8% at 9 to 11 years. Atopic eczema developed in the first 12 months of life in 60% of the children who had the condition, and it developed in the first 6 months of life in three quarters of these children. Ear piercing had been performed in 35% of girls and 3% of boys and was most prevalent in social classes 3, 4, and 5. More than half the girls aged 9 to 11 years had pierced ears. Breast-feeding did not affect the prevalence of atopic eczema. CONCLUSION: The lifetime prevalence of atopic eczema was 20% in children aged 3 to 11 years. There was no evidence that ear piercing perpetuated eczema in this age group. Breast-feeding did not protect against the development of atopic eczema.

The prevalence of headache and migraine in atopic children: an epidemiological study in general practice.

The lifetime prevalence of headache and migraine was assessed in an unselected sample of atopic (asthma, eczema or rhinitis) children in a general practice population of known socio-economic and age/sex composition. Maternal migraine was also recorded. The prevalence of both headache and migraine was significantly and proportionally higher in children with atopic disorders compared to those without. Childhood migraine was associated with atopy and the association was strongest with rhinitis. Rhinitis in children was associated with maternal migraine. A history of atopy (especially rhinitis) supports the diagnosis of migraine in young children with paroxysmal headaches.

Clinical epidemiology of childhood abdominal migraine in an urban general practice.

The present study examined the epidemiology of abdominal migraine among 1104 children registered with a general practice. There was a similar prevalence of recurrent abdominal pain as in other studies (8.4 per cent). The prevalence of headache was higher among children with recurrent abdominal pain and significantly so among girls. Migrainous headache was not significantly more prevalent in children with recurrent abdominal pain. The prevalence of abdominal migraine with and without migrainous headache was 0.7 and 1.7 per cent, respectively. The peak prevalence of abdominal migraine without migrainous headache was between five and seven years for both sexes. When associated with migrainous headache, it peaked at five to seven years in girls and seven to nine years in boys. The syndrome was associated with travel sickness and was more common among girls and those with a maternal history of migraine. Many children were photo- and phonophobic during an attack.

Epidemiology of headache and childhood migraine in an urban general practice using Ad Hoc, Vahlquist and IHS criteria.

In a survey conducted by a UK urban general practice, 98.1 per cent (1083) of the children registered aged three to 11 years took part in an interview. Possible migraine subjects took part in an extended interview, the results of which were recorded using three different sets of diagnostic criteria: Vahlquist, Ad Hoc and International Headache Society. The prevalence of migraine ranged from 3.7 to 4.9 per cent, depending on the criteria used. The prevalence of migraine with aura (1.5 per cent) was similar by all criteria, whereas that for migraine without aura ranged from 2.2 to 3.4 per cent. The prevalence of migraine increased with age. The IHS criteria appeared less sensitive than the Ad Hoc for migraine without aura. Operational criteria using three attacks lasting longer than one hour may be more specific for the diagnosis of migraine in young children.

Childhood migraine in general practice: clinical features and characteristics.

Previous studies have evaluated the clinical features and characteristics of migraine in selected children attending hospital clinics. There have, however, been no community studies on the prevalence and characteristics of migraine in children aged 3-11 years in British general practice. In this study, a total of 1,083 children (from 1,104 registered with a general practice) and their parents were interviewed. Possible migraine sufferers took part in an extended interview that assessed various characteristics of the patients and their attacks. The survey showed that migraine attacks started in infancy, and migrainous children were more likely to have mothers with migraine. Some clinical features were found to be age-dependent. Compared with similar hospital surveys there was a lower frequency of attacks recorded but the prevalence of aura was similar to that found in previous studies.

Does a history of maternal migraine or depression predispose children to headache and stomach-ache?

The incidence of the life time history of both maternal migraine and depression were assessed in children with headache, migraine, recurrent abdominal pain and abdominal migraine. An epidemiological survey of 1,104 children registered with a general practice was undertaken. The incidence of maternal migraine and depression agreed with previous estimates. Children with migraine had a greater proportion of mothers with a history of migraine than those who experienced headache alone compared with controls. The survey showed that mothers with depression predisposed their children to headache but not specifically migraine. A history of maternal depression and migraine was significantly more common and proportionately higher in children with abdominal migraine and recurrent abdominal pain.

The use of tinted glasses in childhood migraine.

20 children with clinically diagnosed migraine were asked to wear either a rose coloured tint or density matched blue tint for a period of 4 months. The frequency, duration and intensity of migraine attacks were recorded, together with the amount of visually provoked beta activity in the EEG. After one month's wear all the children in the study revealed an initial improvement in headache frequency. However, only those children wearing rose tints sustained this improvement up to 4 months, when the mean headache frequency had improved from 6.2 per month to 1.6 per month. The headache frequency of those children wearing blue tints revealed no overall improvement after 4 months. The improvements in headache frequency in children wearing rose tints correlated with a reduction in visually provoked beta activity.

The VER as a diagnostic marker for childhood abdominal migraine.

Abdominal migraine is a common childhood migraine equivalent, for which diagnostic criteria have not been defined. As in other children with migraine equivalents this leads to difficulties in diagnosis and determination of prevalence. By recording the fast wave activity (beta rhythmn) in the visual evoked response (VER) to red and white flash, the pattern stimulation, 27 out of 28 children with clinically diagnosed abdominal migraine revealed significant differences compared with normal controls, outside the attack phase. Comparisons with children diagnosed as migraine with or without aura revealed, from the VER findings of higher amplitude fast wave activity and the presence of paroxysmal sharp wave activity, that abdominal migraine appears to be a specific form of childhood migraine. We found that both clinically and electrophysiologically, abdominal migraine changes with age; older children exhibiting a shorter duration of abdominal pain during attacks, and less evidence of sharp wave activity in the VER.

The VEP in acephalgic migraine.

The diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms. Using both flash and pattern stimulation, visual evoked potentials (VEPs) were examined as a means of differentiating between acephalgic migraine, migraine with aura, migraine without aura, demyelinating disease and a control group. This study demonstrated that by analysing the amplitude of the background fast activity in the flash and pattern VEP, acephalgic migraine can be differentiated from demyelinating disease, migraine with aura, migraine without aura and absolute controls.

Visual evoked responses in children with migraine: a diagnostic test.

The visual evoked responses (VERs) to both flash and pattern stimulation were recorded in 44 children with migraine, with or without aura, and 8 with periodic syndrome. The controls were 50 age and sex matched children. VERs of 50 sex matched adults with migraine were also recorded. The fast wave amplitude in children with migraine was higher than that in controls. The amplitude was higher in younger children with migraine (under 13 years) than that in older children or adults with migraine. Children with periodic syndrome had VERs similar to those of children with migraine. The VER, especially in children, may prove to be a useful test in the diagnosis of migraine.