Prognosis of headache in children: a 25-year follow-up

Childs Nerv Syst. 2022 Mar;38(3):619-626. doi: 10.1007/s00381-021-05420-4. Epub 2022 Jan 21.


Aim: To describe the natural history, evaluate the long-term prognosis, and identify predictors of a favorable outcome of childhood migraines in a cohort of children who had been diagnosed with migraine 25 years before.

Methods: One hundred eighteen children with headache (ages 2 to 15), observed in a headache outpatient clinic of a University Hospital in 1994, by one of the authors, were revaluated in 2019/2020 by a standardized telephone interview specifying headache characteristics, treatment, precipitants, and family history. Headache diagnosis at follow-up was based on ID-Migraine and confirmed by a semistructured interview.

Results: Revaluation was achieved for 88 (75%) patients (43 with migraine), 47 women and age average 41.2 ± 3.2. Over the follow-up (average 25.5 years), 33% of the patients had experienced remission, 41% maintained the same diagnosis, and 26% evolved into a different headache. Sixty six percent reported an improvement. Only eight patients were attending regular consultations because of headache. Male sex came out as the only predictor of a favorable outcome.

Conclusion: Most patients (66%) with pediatric headache continue to experience headache although reporting a significant improvement. Boys tended to remit more often than girls. This data suggests that age, genetics, and hormonal factors may play an important role in migraine phenotypic expression.

Keywords: Evolution; Follow-up; Headache; Migraine; Pediatric; Prognosis.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Headache* / diagnosis
  • Headache* / epidemiology
  • Humans
  • Male
  • Migraine Disorders* / diagnosis
  • Migraine Disorders* / epidemiology
  • Migraine Disorders* / therapy
  • Prognosis