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Brain 2018 Dec;141(12):3308-3318

MRC Centre for Neuromuscular Diseases, Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK.

Hypokalaemic periodic paralysis is a rare genetic neuromuscular disease characterized by episodes of skeletal muscle paralysis associated with low serum potassium. Muscle fibre inexcitability during attacks of paralysis is due to an aberrant depolarizing leak current through mutant voltage sensing domains of either the sarcolemmal voltage-gated calcium or sodium channel. We report a child with hypokalaemic periodic paralysis and CNS involvement, including seizures, but without mutations in the known periodic paralysis genes. Read More

Klin Padiatr 2018 Oct 15. Epub 2018 Oct 15.

Zentrum für Kinder- und Jugendmedizin Olgahospital, Pädiatrische Neurologie, Psychosomatik und Schmerztherapie, Kinderschmerzzentrum Baden-Württemberg, Stuttgart.

Primary headache disorders such as migraine and tension-type headache begin as early as childhood or adolescence. Prevalence increases during primary school and adolescence. In tension-type headache, central pain sensitization and activation of central nociceptive neurons plays an important role. Read More

Cochrane Database Syst Rev 2018 09 29;9:CD003968. Epub 2018 Sep 29.

Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Oxford, UK.

Background: This is an update of the original Cochrane review first published in Issue 1, 2003, and previously updated in 2009, 2012 and 2014. Chronic pain, defined as pain that recurs or persists for more than three months, is common in childhood. Chronic pain can affect nearly every aspect of daily life and is associated with disability, anxiety, and depressive symptoms. Read More

J Med Genet 2018 Dec 28;55(12):831-836. Epub 2018 Sep 28.

The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Background: Genome-wide association studies (GWASs) have identified multiple susceptibility loci for migraine in European adults. However, no large-scale genetic studies have been performed in children or African Americans with migraine.

Methods: We conducted a GWAS of 380 African-American children and 2129 ancestry-matched controls to identify variants associated with migraine. Read More

Eur J Paediatr Neurol 2018 Aug 15. Epub 2018 Aug 15.

Department of Pediatric Neurology & Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

Objective: To describe the clinical spectrum of benign nocturnal alternating hemiplegia of childhood (BNAHC) including long-term follow-up data of previously published cases and to propose an underlying genetic cause of this disorder.

Methods: We studied the medical data of two novel patients, reviewed the literature on BNAHC, and gathered information of the most recent follow-up of published cases regarding the course of episodes, further development, attempted drugs, ancillary investigations, and sequelae.

Results: All patients, i. Read More

Continuum (Minneap Minn) 2018 Aug;24(4, Headache):1108-1136

Purpose Of Review: This article provides the practicing neurologist with a comprehensive, evidence-based approach to the diagnosis and management of headache in children and adolescents, with a focus on migraine.

Recent Findings: Four triptans are now labeled by the US Food and Drug Administration (FDA) for acute migraine treatment in adolescents, and rizatriptan is labeled for use in children age 6 and older. For preventive migraine treatment, the Childhood and Adolescent Migraine Prevention trial demonstrated that approximately 60% of children and adolescents with migraine will improve with a three-pronged treatment approach that includes: (1) lifestyle management counseling (on sleep, exercise, hydration, caffeine, and avoidance of meal skipping); (2) optimally dosed acute therapy, specifically nonsteroidal anti-inflammatory drugs and triptans; and (3) a preventive treatment that has some evidence for efficacy. Read More

Curr Pain Headache Rep 2018 Jun 14;22(7):50. Epub 2018 Jun 14.

Center for Pain Medicine, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA.

Purpose Of Review: Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine, is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. This review discusses the clinical presentation, current understanding of the pathophysiology, key differential diagnoses, and evaluation and treatment of RPON.

Recent Findings: The literature is limited due to the rarity of the disorder. Read More

J Clin Psychiatry 2018 May/Jun;79(3)

Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India.

Valproate and formulations thereof are approved for the management of seizure disorders, bipolar disorder, and migraine. Valproate is also used for many off-label indications. Unfortunately, data from observational studies indicate that valproate is perhaps the most teratogenic drug in the neuropsychiatric pharmacopeia. Read More

Front Psychol 2018 14;9:704. Epub 2018 May 14.

Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.

Many factors are involved in the prognosis and outcome of Chronic Migraine and Medication Overuse Headache (CM+MOH), and their understanding is a topic of interest. It is well known that CM+MOH patients experience increased psychiatric comorbidity, such as anxiety, depression, or personality disorders. Other psychological factors still need to be explored. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018;118(4):100-106

Pirogov Russian National Research Medical University, Moscow, Russia.

Migraine and epilepsy represent prevalent chronic neurological disorders of childhood. Migraine and epilepsy comorbidity relies on the common pathophysiologic and genetic mechanisms of the paroxysmal disorders the similarity of their precipitating factors, clinical manifestations and therapeutic approaches. The problems of differential diagnosis of migraine and epilepsy are related to peculiarities of migraine manifestations in children. Read More

Otolaryngol Pol 2018 Apr;72(2):50-59

ENT Department, Policlinico S.M. alle Scotte Siena, viale Bracci n.16, 53100, Italy.

Introduction: Migraine and allergies are a common occurrence. The aim of this study was to investigate the relationship between respiratory allergy and migraine in childhood.

Materials And Methods: We screened 800 children for headache and its characteristics. Read More

Curr Pain Headache Rep 2018 May 3;22(6):42. Epub 2018 May 3.

Juvenile Headache Centre, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy.

Purpose Of Review: The purpose of this work was to review the current literature on the epidemiology and pathophysiology of pediatric obesity and migraine, underlying pathogenic mechanisms that may explain the association between the two disorders, and the effects of treatment.

Recent Findings: In children and adolescents, the bulk of the available data support an association between obesity and headache disorders in general, though a small number of studies contradict these findings. Relative to the adult population, however, few studies have focused specifically on migraine, and no wide-ranging meta-analyses have been conducted to date. Read More

Eur J Paediatr Neurol 2018 Jul 30;22(4):667-673. Epub 2018 Mar 30.

Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Introduction: Migraine variant disorders of childhood include benign paroxysmal torticollis of infancy (BPTI) and benign paroxysmal vertigo of childhood (BPVC). This study aimed to review our experience with BPTI and BPVC and determine the incidence of children transitioning between each of these disorders and to vestibular migraine (VM).

Methods: We retrospectively reviewed the medical records of patients seen at the Balance and Vestibular Program at Boston Children's Hospital between January 2012 and December 2016 who were diagnosed with BPTI, BPVC, and/or VM. Read More

Dev Med Child Neurol 2018 11 14;60(11):1117-1122. Epub 2018 Apr 14.

Murdoch Children's Research Institute, Parkville, Vic., Australia.

Aim: To estimate the strengths of association between clinical features and migraine or arterial ischaemic stroke (AIS) in children presenting to the emergency department.

Method: Eighty-four children with migraine, prospectively recruited from 2009 to 2010, were compared with 55 children with AIS, prospectively/retrospectively recruited from 2003 to 2010. Odds ratios were calculated via logistic regression to measure associations between clinical features and process-of-care factors, and migraine and AIS. Read More

Cephalalgia 2018 Dec 8;38(14):2017-2025. Epub 2018 Apr 8.

1 Paediatric Department, Queen's University Hospital, London, UK.

Aim: To examine the characteristics of visual symptoms during attacks of migraine in children and adolescents.

Method: A qualitative analysis of prospectively collected data over 5 years, on characteristics of visual symptoms during migraine attacks. Diagnosis of migraine and aura was based on the International Classification of Headache Disorders 3 edition beta version. Read More

Curr Opin Neurol 2018 06;31(3):281-285

Division of Child Neurology, Department of Neurology, University of California San Francisco, San Francisco, California, USA.

Purpose Of Review: This review covers recent advances in our understanding of episodic syndromes that may be associated with migraine in children and adolescents, as well as what is known about the treatment of these disorders.

Recent Findings: The episodic syndromes include benign paroxysmal torticollis, benign paroxysmal vertigo, abdominal migraine, and cyclic vomiting syndrome. Infant colic, or excessive crying in an otherwise healthy and well fed infant, may also fit into this category and is included in the appendix section of the most recent edition of the International Classification of Headache Disorders. Read More

Curr Pain Headache Rep 2018 Mar 19;22(4):30. Epub 2018 Mar 19.

Department of Evaluation and Treatment of Pain, Clinical Neuroscience Federation, La Timone Hospital, FHU INOVPAIN, Marseille, France.

Purpose Of Review: Cyclic vomiting syndrome (CVS) is a misrecognized and probably underdiagnosed episodic syndrome associated with migraine, occurring preferentially in childhood. Attacks are stereotyped for each individual, with predictable periodicity. This review summarizes recent clinical and paraclinical observations in this syndrome, and current approaches in explorations and therapeutics. Read More

Front Neurol 2018 5;9:78. Epub 2018 Mar 5.

Basic Medical Sciences, Neuroscience and Sense Organs Department, University of the Study of Bari Aldo Moro, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy.

Headache is one of the most common neurological disorders in developmental age. Several studies investigated the relationship between headache and emotional/behavioral problems. We studied non-verbal cognitive abilities, including non-verbal memory and attention skills, in order to evaluate the impact of primary headache on these domains. Read More

AJNR Am J Neuroradiol 2018 May 15;39(5):935-941. Epub 2018 Mar 15.

Department of Radiology (K.W.Y.), Lucile Packard Children's Hospital, Stanford University, Stanford, California.

Background And Purpose: Tension-type and migraine-type headaches are the most common chronic paroxysmal disorders of childhood. The goal of this study was to compare regional cerebral volumes and diffusion in tension-type and migraine-type headaches against published controls.

Materials And Methods: Patients evaluated for tension-type or migraine-type headache without aura from May 2014 to July 2016 in a single center were retrospectively reviewed. Read More

Front Neurol 2018 28;9:95. Epub 2018 Feb 28.

Clinic of Child and Adolescent Neuropsychiatry, Center for Childhood Headache, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Introduction: Sleep and migraine share a common pathophysiological substrate, although the underlying mechanisms are unknown. The serotonergic and orexinergic systems are both involved in the regulation of sleep/wake cycle, and numerous studies show that both are involved in the migraine etiopathogenesis. These two systems are anatomically and functionally interconnected. Read More

FP Essent 2018 Mar;466:29-35

University of Missouri School of Medicine - Columbia, 1 Hospital Dr, Columbia, MO 65212.

Functional gastrointestinal disorders (FGIDs) are common among children and cause tremendous distress for patients and families. Family physicians should know how to diagnose and manage some of the more common childhood FGIDs. These include infant regurgitation, infant colic, infant dyschezia, cyclic vomiting syndrome, functional nausea and vomiting, functional diarrhea and constipation, abdominal migraine, and nonspecific functional abdominal pain. Read More

Pediatr Ann 2018 Feb;47(2):e69-e73

Migraine and tension-type headaches are common primary headache disorders encountered among children and adolescents presenting to a pediatric clinic. At times, children present with a headache with unusual or peculiar features that can be alarming and perplexing. These can be in the form of a brief stabbing headache with lacrimation in one eye or a continuous headache locked to one side of the head or face. Read More

Pediatr Ann 2018 Feb;47(2):e55-e60

Migraine is one of the most common neurologic conditions in pediatrics. It can be a significant stressor, causing absences from school and interruption of parents' work and family schedules. The mainstay of treatment remains educating patients about healthy lifestyle practices and the influences of sleep, stressors, and hydration on triggering migraine attacks. Read More

Eur J Paediatr Neurol 2018 May 10;22(3):380-386. Epub 2018 Jan 10.

Department of Paediatric Haemostaseolgy, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Lindwurmstr. 4, 80337, Munich, Germany.

Objective: Acute treatment of childhood arterial ischaemic stroke and prevention strategies for recurrent stroke episodes depend strongly on each child's individual risk profile. The aim of this study is to characterize risk factors for childhood stroke, their occurrence in isolation or combination, and to identify possible common risk factor patterns.

Methods: This population-based study was conducted via ESPED, a surveillance unit for rare paediatric diseases in Germany. Read More

J Headache Pain 2018 Jan 16;19(1). Epub 2018 Jan 16.

Department of Paediatric Neurology, Great Ormond Hospital for Children NHS Foundation Trust, London, UK.

Background: Pediatric headache disorders can be extremely disabling, with marked reduction in the quality of life of children and their carers. Evidenced-based options for the treatment of primary headache disorders with preventive medication is limited and clinical outcomes are often unsatisfactory. Greater occipital nerve injections represent a rapid and well-tolerated therapeutic option, which is widely used in clinical practice in adults, and has previously shown a good outcome in a pediatric population. Read More

Noro Psikiyatr Ars 2017 Dec;54(4):291-294

Clinic of Neurology, Bağcılar Training and Research Hospital, İstanbul, Turkey.

Introduction: The aim of this study is to investigate the association between childhood traumatic events and headache-related clinical parameters in migraine patients.

Methods: 95 patients diagnosed with migraine and 50 healthy controls were included in the study. A socio-demographic form, the Childhood Trauma Questionnaire (CTQ), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were completed by all participants. Read More

Front Neurol 2017 12;8:680. Epub 2017 Dec 12.

Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.

Object: About 1.2-3.2% of children at 7 years of age with increasing age up to 4-19% in adolescents are suffering from migraine without aura (MwA). Read More

Otol Neurotol 2018 Mar;39(3):344-350

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital.

Objective: This study aimed to characterize the clinical features and outcomes of benign paroxysmal positional vertigo (BPPV) in the pediatric population.

Study Design: Retrospective case review.

Setting: Tertiary care center. Read More

J Headache Pain 2017 Nov 29;18(1):113. Epub 2017 Nov 29.

Department of Pediatrics and Child and Adolescent Neuropsychiatry, Sapienza University, Rome, Italy.

Background: The 2013 International Classification of Headache Disorders-3 was published in a beta version to allow clinicians to confirm the validity of the criteria or suggest improvements based on field studies. The aim of this work was to review the Secondary Headache Disorders and Cranial Neuralgias and Other Headache Disorders sections of ICHD-3 beta data on children and adolescents (age 0-18 years) and to suggest changes, additions, and amendments.

Methods: Several experts in childhood headache across the world applied different aspects of ICHD-3 beta in their normal clinical practice. Read More

J Headache Pain 2017 Nov 23;18(1):109. Epub 2017 Nov 23.

Department of Pediatrics and Child and Adolescent Neuropsychiatry, Sapienza University, Rome, Italy.

Background: The 2013 International Classification of Headache Disorders-3 (ICHD-3) was published in a beta version to allow the clinicians to confirm the validity of the criteria or to suggest improvements based on field studies. The aim of this work was to review the Primary Headache Disorders Section of ICHD-3 beta data on children and adolescents (age 0-18 years), and to suggest changes, additions, and amendments.

Methods: Several experts in childhood headache across the world applied different aspects of ICHD-3 beta in their normal clinical practice. Read More

Headache 2018 Apr 4;58(4):534-544. Epub 2017 Dec 4.

ENT Department, San Raffaele Scientific Hospital, Milan, Italy.

Objective: The aim of this work was to assess through a questionnaire the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors in a sample of 252 subjects with a diagnosis of definite vestibular migraine.

Background: Migraine is a common neurological disorder characterized by episodic headaches with specific features. About two-thirds of cases run in families, and patients may refer symptoms occurring in infancy and childhood, defined as episodic syndromes that may be associated with migraine. Read More

Pediatr Neurol 2017 Dec 14;77:67-72. Epub 2017 Sep 14.

Department of Neurology, University of Virginia, Charlottesville, Virginia.

Background: Risk of multiple sclerosis (MS) is influenced by environment and genetics. Infant breastfeeding appears protective against some childhood autoimmune disorders, but its impact on risk of MS in childhood is unknown. The objective of this study is to analyze the association of breastfeeding in infancy on future risk of pediatric-onset MS. Read More

Nervenarzt 2017 Dec;88(12):1402-1410

Abteilung für Pädiatrische Neurologie und Entwicklungsneurologie, LMU Zentrum - iSPZ Hauner, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Universität München, Lindwurmstr. 4, 80337, München, Deutschland.

Migraine as primary headache is a life-long disease which is relevant for the quality of life and is based on complex genetics. It often starts in childhood with symptoms typical for the specific age. These show different nuances compared to the migraine symptoms in adults, for example, regarding (bilateral/unilateral) localization of the acute migraine headache. Read More

Lancet 2017 Sep;390(10100):1211-1259

Background: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016.

Methods: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. Read More

Iran J Child Neurol 2017 ;11(3):37-41

Pediatrics Growth Disorders Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Objective: Migraine is the mosyndrome and infantile colic is a common cause of infantile cry. The pathogenesis of migraine and colic has not been well established and different factors may cause them. There is an association between infantile colic and the occurrence of childhood migraine. Read More

Arch Pediatr 2017 Oct 1;24(10):1010-1012. Epub 2017 Sep 1.

Service de neuropédiatrie CHU UCL-Namur, place L.-Godin, 15, 5000 Namur, Belgique; Institut de pathologie et de génétique, avenue G.-Lemaître, 25, 6041 Charleroi, Belgique.

New genetic techniques have made it possible to better understand the implications of the PRRT2 gene (proline rich transmembrane protein 2) in various neurological disorders. Mutations within this gene are responsible for kinesigenic paroxysmal dyskinesias (PKD) as well as for benign familial infantile epilepsy (BFIE), a disease associating infantile convulsions and choreoathetosis (ICCA), a form of familial hemiplegic migraine (FHM type 4), paroxysmal benign torticollis of childhood, and episodic ataxia. We describe the case of an infant, carrying a mutation of the PRRT2 gene, with a classical presentation. Read More

Pediatr Neurol 2017 Oct 8;75:87-90. Epub 2017 Jun 8.

Division of Neurology, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada. Electronic address:

Background: Pathogenic heterozygous variants in the ATP1A2 gene have most commonly been associated with familial hemiplegic migraine. However, a wide spectrum of phenotypes that include alternating hemiplegia of childhood and epilepsy have been described.

Patient Description: We describe a boy who presented at age three months with a complex phenotype that included epilepsy, nonepileptic paroxysmal events, and recurrent hemiplegia. Read More

Curr Pain Headache Rep 2017 Aug;21(8):38

Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave-MLC 2015, Cincinnati, OH, 45229-3039, USA.

Purpose Of Review: Headaches in children are quite common; however, the study and characterization of headache disorders in the pediatric age group has historically been limited. Because of the lack of controlled studies on prophylactic treatment of headache disorders in this age group, the diagnosis of migraine rests on criteria similar those in adults. Likewise, data from adult studies is often inferred and applied to children. Read More

Int J Public Health 2018 Mar 24;63(2):181-192. Epub 2017 Jul 24.

Health Services Research Unit, Department of Community Medicine, University of Tromsø, 9037, Tromsø, Norway.

Objectives: The aim of this study was to (1) identify the influence of childhood socioeconomic status (CSES) on five chronic conditions: asthma, bronchitis, hypothyroid, migraine, and psychiatric disorders in later life; (2) determine the mediating role of childhood abuse (CA) in these associations, and (3) quantify recall bias due to respondent's mental health in these associations.

Methods: 10,325 men and women from the Tromsø Study were followed for 13 years, and Poisson regression models were used.

Results: Low CSES was associated with a 16-23% higher risk of chronic conditions, and CA was associated with a 16-58% higher risk of chronic conditions (p < 0. Read More

Acta Paediatr 2017 Dec 11;106(12):1961-1965. Epub 2017 Aug 11.

Paediatric Migraine Centre, Armand Trousseau Hospital, APHP, Paris, France.

Aim: The aim of this study was to examine the course of headache diagnosis, headache frequency, anxiety, comorbid depressive symptoms and school absenteeism in adolescents with migraine and tension-type headaches five years after baseline.

Methods: We followed a group of 122 children with a mean age of 10.1 (±1. Read More

Curr Pain Headache Rep 2017 Jul;21(7):34

NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, Denmark Hill, London, SE5 9PJ, UK.

Purpose Of Review: Premonitory symptoms in migraine; symptoms occurring before the onset of migraine pain or aura, are an increasingly recognised area of interest within headache research. It has been recently documented in the literature that these symptoms also occur in children and adolescents, with a comparable phenotype to adults. This review discusses the wide presentation of premonitory symptoms in migraine in children and adolescents, and the importance of understanding how these early symptoms are mediated in order to ensure that targeted abortive therapies are developed in the future. Read More

J Atten Disord 2017 Jun 1:1087054717710767. Epub 2017 Jun 1.

4 Teva Pharmaceuticals Research and Development, Frazer, PA, USA.

Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g. Read More

J Headache Pain 2017 Dec 30;18(1):59. Epub 2017 May 30.

Psychological Pediatric Service, Bari Policlinico General Hospital, Bari, Italy.

Background: Central sensitization is an important epiphenomenon of the adult migraine, clinically expressed by allodynia, pericranial tenderness and comorbidity for fibromyalgia in a relevant number of patients. This study aimed to evaluate the frequency and the clinical characteristics of allodynia, pericranial tenderness, and comorbidity for Juvenile Fibromialgia (JFM) in a cohort of migraine children selected in a tertiary headache center.

Methods: This was an observational cross-sectional study on 8-15 years old migraine patients. Read More

Headache 2017 Jun 10;57(6):943-951. Epub 2017 May 10.

Department of Evaluation and Treatment of Pain, La Timone Hospital, Marseille, France.

Objective: To see how patients' clinical descriptions compare to the third classification of International Classification of Headache Disorders (ICHD-III beta).

Background: CVS is an episodic syndrome associated with migraine. It is a rare disorder of childhood and adulthood. Read More

J Child Neurol 2017 07 24;32(8):754-758. Epub 2017 Apr 24.

1 Service de neuropédiatrie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France.

The objective was to study the prevalence and characterization of pediatric migraine triggers and to compare results to this retrospective study. A total of 101 pediatric patients with ICHD-II migraine with and/or without aura were instructed to prospectively complete a diary dealing with attacks triggers for a 3-month period. Each subject reported at least 1 trigger (range: 1-14) with a total number of 532 attacks and a median per subject of 3. Read More

Pediatr Ann 2017 Apr;46(4):e155-e165

Headaches are common in childhood and adolescence and can cause significant distress and disability for a child and their family. Providers need to be able to identify "red flags" for worrisome causes of secondary headaches and recognize typical primary headache characteristics to provide each patient with the best possible care to improve their quality of life and minimize disability. This article reviews the epidemiology of headaches in children, signs and symptoms of secondary headaches, definitions of some primary childhood headaches, and options for management of both acute and chronic pediatric migraine. Read More

Stroke 2017 05 23;48(5):1198-1202. Epub 2017 Mar 23.

From the Department of Neurology (M.T.M.), Department of Haematology (P.M.), and Emergency Department (F.B.), Royal Children's Hospital Melbourne, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia (M.T.M., F.B.); Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia (M.T.M., L.C., G.A.D.); University of Melbourne, Parkville, Victoria, Australia (M.T.M., L.C., P.M., G.A.D., F.B.); and Emergency Department, Hospital Nacional de Ninos, San Jose, Costa Rica (A.Y.-C.).

Background And Purpose: Access to acute stroke interventions in the emergency department (ED) relies on correct clinical diagnosis. Our aims were to determine the accuracy and reliability of pediatric ED physician diagnosis of childhood stroke and other conditions presenting with brain attack symptoms.

Methods: Prospective study of consecutive children aged 1 month to 18 years presenting to the ED from June 2009 to December 2010 with focal neurological deficits. Read More