INTRODUCTION The diagnosis of migraine is based entirely on clinical data, and generally accepted and valid criteria should be applied as a common diagnostic reference. AIMS. The aim of this work was to study the epidemiological and clinical characteristics of migraine in the paediatric age and to analyse the validity of the criteria used in its diagnosis.

PATIENTS AND METHODS A total of 290 histories of patients with recurring headaches (150 with migraine and 140 with non-migraine headaches) were reviewed, epidemiological and clinical data were collected, and complementary examinations were performed, when necessary. The sensitivity, specificity and likelihood ratio of the Vahlsquit, Prensky and IHS criteria for migraine were all calculated.

RESULTS 32% of cases were migraines with aura. The age of onset of migraine was 8.7±2.9 years, with no differences between sexes. Nevertheless, in migraine with aura the age of onset (9.8±3.3 years) and prevalence of females (63.3%) were significantly higher (p < 0.05). Family history was positive in 77.3% of the cases. In migraine, the pain was unilateral (44.4%) or bilateral (55.6%), throbbing (93.7%), interrupted daily activities (63.2%), got worse on doing exercise (68.1%) and was accompanied by nausea (70.1%) and sensitivity to light and sound (66.2%). The throbbing quality, vomiting, one-sidedness and moderate to severe intensity were the items that displayed the greatest discriminating capacity and the IHS criteria were those with the highest diagnostic validity. Diagnosis was not altered by the complementary examinations.

CONCLUSIONS Migraine is a common pathology among children in the paediatric age and generally begins in the school age. The IHS criteria allow it to be diagnosed, although monitoring its progress would be the reference test with which to validate the diagnostic criteria.

Introducción El diagnóstico de la migraña se basa exclusivamente en datos clínicos, y conviene aplicar criterios consensuados y válidos como referencia diagnóstica común.

Objetivo Estudiar las características epidemiológicas y clínicas de la migraña en la edad pediátrica y analizar la validez de los criterios utilizados en su diagnóstico.

Pacientes y métodos Se han revisado 290 historias de pacientes con cefaleas recurrentes (150 con migraña y 140 con cefaleas no migrañosas), y se han recogido datos epidemiológicos y clínicos y, en su caso, exámenes complementarios. Se ha calculado la sensibilidad, la especificidad y el cociente de verosimilitud de los criterios de Vahlsquit, Prensky y de la IHS para la migraña.

Resultados El 32% de las migrañas tenían aura. La edad de inicio de la migraña era de 8,7±2,9 años, sin diferencias entre sexos. No obstante, en la migraña con aura la edad de comienzo (9,8±3,3 años) y la prevalencia del sexo femenino (63,3%) eran significativamente mayores (p < 0,05). La historia familiar era positiva en el 77,3% de los casos. En la migraña el dolor era unilateral (44,4%) o bilateral (55,6%), pulsátil (93,7%), interrumpía la actividad diaria (63,2%), empeoraba con el ejercicio (68,1%) y se acompañaba de vómitos (70,1%) y fotofobia/sonofobia (66,2%). El carácter pulsátil, los vómitos, la unilateralidad y la intensidad moderada-grave eran los ítems de mayor capacidad discriminatoria, y los criterios de la IHS los de mayor validez diagnóstica. Los exámenes complementarios no modificarán el diagnóstico.

Conclusiones La migraña es una patología común en la edad pediátrica, de inicio preferentemente en la edad escolar. Los criterios de la IHS permiten su diagnóstico, aunque el control evolutivo sería la prueba de referencia para validar los criterios diagnósticos.