Migraine in childhood behaves slightly differently from migraine in adults. As we have already seen it can sometimes occur as stomach pain — abdominal migraine.

However, many children get common or classical head migraines, sometimes alternating between the abdominal and head pain; and others get abdominal pain at the time that the aura would occur in an adult.

Even in children with normal migraine, there are differences between childhood and adult attacks. In children, attacks tend to be frequent and severe, though normally slightly shorter than in adults, and there can be long periods in between the bouts. Incomplete attacks are common. There may be many more generalised symptoms — nausea, vomiting, sweating, passing water frequently, or water retention.

In children there is an association between migraine and travel sickness and with dizziness. It is possible also that repeated attacks of unexplained vomiting (the so-called ‘periodic’ syndrome) actually are a form of migraine. It may develop into full migraine in later life.

Before puberty, migraine occurs more often in males, which is the reverse of the over-all picture, but after puberty the oestrogen levels of young girls rise. It is oestrogen which is the factor responsible for the preponderance of migraine in women. Basilar migraine is most common in adolescent girls, and ophthalmoplegic migraine in young boys.

The relationship between childhood and adult migraine isn’t certain; some lose their attacks only to get them back later. However, of those who have migraine in childhood, approximately half will have slopped having attacks by the age of thirty.

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