Cyclic vomiting syndrome and benign paroxysmal torticollis are associated with a high risk of developing primary headache: A longitudinal study.

Authors:
Romina Moavero
Romina Moavero
Tor Vergata University
Italy
Laura Papetti
Laura Papetti
Sapienza University of Rome
Italy
Caterina Cenci
Caterina Cenci
University of Florence
Italy
Federico Vigevano
Federico Vigevano
Bambino Gesù Children's Hospital
Italy
Massimiliano Valeriani
Massimiliano Valeriani
Division of Neurology
Plovdiv | Bulgaria

Cephalalgia 2019 Apr 13:333102419844542. Epub 2019 Apr 13.

1 Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Background And Aim: Episodic syndromes that may be associated with migraine are a group of disorders affecting patients with migraine or with an increased risk of presenting it, and likely represent an early life expression of migraine. Cyclic vomiting syndrome and benign paroxysmal torticollis are well characterized and represent a frequent cause of request for specialist consultations. The aim of this study is to longitudinally assess the rate of headache in patients presenting with cyclic vomiting syndrome and benign paroxysmal torticollis during infancy, and to define the main clinical features of the disorder.

Methods: We administered a questionnaire to the parents of all our pediatric patients with previous diagnosis of cyclic vomiting syndrome and/or benign paroxysmal torticollis according to ICHD-3; questions were focused on the main clinical features of the disorder as well as the prognosis, with particular emphasis on the development of headache.

Results: For the final analysis we considered 82 patients with cyclic vomiting syndrome and 33 with benign paroxysmal torticollis. Seventy-nine percent of patients with cyclic vomiting syndrome presented with headache during the follow-up, with a mean age at onset of 6 years; 67% of patients with benign paroxysmal torticollis suffered from headache during the follow-up, with a mean age at onset of 5 years.

Discussion: Cyclic vomiting syndrome and benign paroxysmal torticollis are associated with a very high risk of developing headache, mostly migraine, later in life. In both groups of patients, the vast majority presented with different episodic syndromes that may be associated with migraine at different ages, thus suggesting an age-dependent evolution of migraine-like symptoms before the onset of clear migrainous headache.

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http://dx.doi.org/10.1177/0333102419844542DOI Listing
April 2019
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