IntroductionRecurring primary headaches, such as migraine or tension-type, are common during childhood (2.5%) and adolescence (15%) [1]. However, while ever increasing evidence shows that migraine is a complex neurovascular disorder with genetic factors playing a primary role in its aetiology, none of the genetic factors which have to date been shown to be linked to adult migraine susceptibility have been investigated in children, for whom primary headaches represent frequent causes for referral for neurologic assessment. In addition, while epidemiological, twin and family studies have revealed that approximately one-half of its variation is attributable to additive genes, with a negligible contribution of nonadditive genetic effects [2], the identification and validation of the underlying genetic risk factors poses enormous challenges even in adult migraine. The severity of migraine symptoms, such as the recurrence and duration of attacks and the age of onset, are variable among patients, thus rendering difficult both the definition of the appropriate phenotype as J Headache Pain (2005) Genetic polymorphisms have been evaluated in association studies, some of which have been suggested to be susceptibility markers for adult migraine. To date, however, none of the identified polymorphisms in adult migraine susceptibility have been investigated in children, raising the possibility that they may not be necessarily involved in paediatric migraine susceptibility. This paper reviews studies of the genetic basis of migraine and summarises our experience in genetic association studies in primary paediatric headache susceptibility.6:179-181 DOI 10.1007/s10194-005-0178-x Genetic risk factors in primary paediatric versus adult headache: complexities and problematics G E N E