All issues > Volume 52(5); 2009

Original Article

Korean J Pediatr. 2009;52(5):557-566. Published online May 15, 2009.

Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II)

Jae Yong JY Park¹, Sang-Ook SO Nam², So-Hee SH Eun³, Su Jeong SJ You⁴, Hoon-Chul HC Kang⁴, Baik-Lin BL Eun³, Hee Jung HJ Chung¹

¹Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital
²Department of Pediatrics, Pusan National University School of Medicine
³Department of Pediatrics, Korea University College of Medicine
³Department of Pediatrics, Korea University College of Medicine
⁴Department of Pediatrics, Inje University College of Medicine

Correspondence Hee Jung HJ Chung ,Email: agathac@nhimc.or.kr

Abstract

Purpose
: To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II.
Methods
: The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared.
Results
: Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was 6.3¡¾3.6 yr, 8.5¡¾2.7 yr, and 8.5¡¾2.9 yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was 8.0¡¾3.4 yr, 10.5¡¾2.6 yr, and 10.1¡¾3.2 yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%).
Conclusion
: The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

Keywords :Childhood periodic syndrome, Migraine headache, Cyclic vomiting syndrome, Abdominal migraine, Benign paroxysmal vertigo of childhood