Definition of migraine headaches in children

The optimal criteria for the diagnosis of migraines without aura in children are controversial. Over the last three decades, there have been several proposed definitions of pediatric migraines. In 1988, the International Headache Society (IHS) proposed a new set of criteria for migraine headaches, but these criteria were developed for headache disorders in adults. We recently conducted a study to assess the agreement between clinical headache diagnoses assigned by pediatric neurologists and symptom- based diagnoses using the IHS criteria as an alternative case definition. The study included eighty eight children with migraines without an aura. Using the clinical diagnosis as the gold standard, the IHS criteria had a sensitivity of 27.3% and a specificity of 92.4%. Based on these findings, we suggest a definition for pediatric migraine headache without aura that is less complex, more sensitive, and almost as specific as the IHS criteria.