Children May Outgrow Migraines
Study Shows 60% Have Either Less Severe or No Headaches by Early 20s
Remission Depends of the Patient
Although most patients improved, about 40% still had persistent headaches.
This included 15 subjects diagnosed with migraine without aura, two with aura, five with migrainous disorder, and one with non-classifiable headache.
The study showed migraine was most likely to persist in adolescents initially diagnosed with migraine without aura and least likely to persist in those initially diagnosed with migrainous disorder or non-classifiable headache.
It also showed a family history of migraine was a strong risk factor for migraine persistence. Adolescents who had parents or siblings with migraine were seven times as likely to still have migraine 10 years later as those whose first-degree relatives were migraine-free.
"Our data suggest that migraine without aura is probably genetically determined," Camarda says.
Public Health Implications
Because migraine without aura is far more common in young adults than migraine with aura, it is an "enormous public health problem," Camarda says.
"Our data have important implications for prevention," Camarda says.
The researcher suggests that aggressive medical treatment of children and teens who have migraine without aura, especially those with a family history of migraine, might lead to eventual remission or to transformation into a less-severe tension-type headache.
Unlike some previous studies, the new one did not confirm that migraine is more likely to persist in girls than boys, although it did show a trend in that direction.
Because the study included only 55 subjects, the association between gender and migraine persistence was probably underestimated, Camarda says.
Larger studies are needed to answer lingering questions about the natural history of migraine, say Camarda and colleagues.
Long Term Prognosis Unclear
"Even if migraine remits, it can reoccur later in life," says Stephen Silberstein, MD, of Thomas Jefferson University in Philadelphia, who was not connected with the new study.
Silberstein says the Italian study "partly replicates" a 1997 Swedish study of 73 children with migraine followed for 40 years.
That study showed that 23% of the children -- boys more often than girls -- were migraine-free by age 25, he says. But it also showed more than half still had migraine attacks at 50.
Contradicting the Italian researchers, Silberstein says he doubts migraine transforms into tension-type headache. "I believe they are just milder attacks of migraine," he tells WebMD.