Postdrome symptoms in pediatric migraine: A questionnaire retrospective study by phone in 100 patients

Abstract

Background No study dedicated to postdrome symptoms of migraine attacks is available in children and adolescents. Objective To study the resolution phase of the migraine attack in children and adolescents. Methods 100 children and adolescents with ICHD-3 beta migraine without and/or with typical aura were included. Each patient, and one of her/his parents, were interviewed by phone about the postdrome phrase of their last six months' migraine attacks. They were specifically instructed to distinguish symptoms that had begun before and went on after migraine headache cessation (referred to as persistent symptoms), and symptoms whose onset was strictly after headache cessation (referred to as true postdromes). Results 91% of patients reported persistent symptoms, with a mean of 2.9 and a median of 2; asthenia, cognitive difficulties, pallor, cognitive slowing, anorexia, somnolence, and nausea were the most frequently reported. They lasted less than 12 h in 71% of patients. True postdromes were reported by 82% of patients, with a mean of 2.6 and a median of 2; thirst, somnolence, visual disturbances, food craving, paraesthesias, and ocular pain being the most frequently reported. They lasted less than 12 h in 94% of patients. Conclusions This study showed that children and adolescents with migraine had both frequent persistent symptoms and true postdromes. Both were notably different from those reported in adults.

Pediatric vs. Adult Prodrome and Postdrome: A Window on Migraine Pathophysiology?

“…Karsan and Goadsby have proposed to group PS starting simultaneously with pain, or occurring during the pain itself under the umbrella term “premonitory-like” as they “have observed that they can start simultaneously with pain, or occur during the pain itself” (37). Some PTS and TPD reported in our study dedicated to the PD in children and adolescents are clearly reminiscent of PS symptoms (14). Several adult studies dedicated to the PD of a migraine attack led to comparable conclusions (34, 35, 38).…”

“…To our knowledge, only three studies dedicated to the PD in the pediatric population (two included children and adolescents only whereas the third concerned both adults and children (11–13)) are available. Data are even scarcer for PD, as there is only one pediatric study dedicated to them (14).…”

“…PD duration was longer in adults, with a mean of 18 h (Blau) and 25.2 h (Kelman) (33, 34). Duration of both PTS and TPD was < 12 h in most patients (14). In one small study ( n = 34), the PD lasted between 30 min and 6 h for most symptoms, but some patients could experience PD which lasted up to 4 days for (33).…”

“…All patients and their parent(s) provided informed written consent for participation in the study, which was approved by the Ethics Committee of Lille Faculty of Medicine. The results have been published elsewhere [see (14) for details and statistical methods] and we will briefly summarized them. Included patients consisted of 100 children and adolescents (49 boys), with an age range of 4–17 and a mean age of 10.5 years.…”

Abdominal migraine

“…Levels of depression and emotional adjustment were similar in children with functional abdominal pain and pain-free controls with minor illnesses 63. Mood change as a premonitory symptom or postdrome is recognised in outpatient studies of paediatric migraine,6465 but there are no specific data on prevalence in abdominal migraine.…”