PEDİATRİC MİGRAİNE PATİENTS İN FİNDİNGS

Overview

Migraine is a common neurological disease in the pediatric population. However, studies investigating the clinical symptoms associated with the different phases of migraine attacks (prodrome, aura, postdrome), particularly in childhood and adolescence, remain limited. The aim of this study was to evaluate the clinical symptoms experienced by children with migraine during attack phases (prodrome, aura, postdrome) and to investigate potential differences in these symptoms according to age and gender The first 18 questions assessed sociodemographic variables, including age, sex, body weight, parental characteristics, social status, age at migraine diagnosis and symptoms, knowledge of migraine, family history of migraine, comorbid conditions, and access to healthcare services. The second part of the questionnaire consisted of questions on headache and migraine-related symptoms and clinical characteristics (questions 19-26), migraine treatment (questions 28-34), and postdrome features (questions 35-39). The study examined migraine-related symptoms and clinical characteristics, treatment approaches, and the influence of sex and age group on the stages of migraine. All patients underwent an assessment of headaches within the last three months, along with physical and neurological examinations. The diagnosis of migraine was made according to the ICHD-III criteria.

A migraine attack consists of four main stages. These stages are premonitory, aura, headache and postdrome periods. The prodromal or premonitory phase of migraine is generally defined as the period 2-48 hours before the aura or migraine headache. 30-90% of migraine patients report such a phase . In the prodromal period, hours or days before the headache, some painless symptoms such as yawning, mood swings, difficulty concentrating, neck pain, fatigue, thirst, and increased frequency of urination may occur. . The prodromal period can last from hours to days. Aura may occur before the onset of a migraine headache. Often, the aura affects the patient's vision. Some patients with migraine may experience confusion, disorientation, tinnitus, dizziness and difficulty speaking, as well as seeing spots, flashes, and zigzags in their field of vision. These symptoms may occur 30 to 60 minutes before or during a migraine attack. Migraine pain can last for hours. During this time, the patient may want to rest in a quiet, dark environment and may have difficulty carrying out daily activities. Pain usually begins in the supraorbital region, particularly around the eyebrows, and then spreads to the unilateral temple region. Migraine has three phases. The prodrome phase is the period that includes the precursor symptoms that occur before the headache, accompanied by changes in the person's mood or cognitive functions, and sometimes accompanied by autonomic and systemic symptoms. If present, auras are monitored during this period. The pain phase includes the time when the headache occurs and ends after the prodromal period. Migraine postdrome phase is the period after the migraine attack until the headache symptoms disappear and return to normal. In the postdrome phase, patients usually report activity-limiting neuropsychiatric, sensory, and gastrointestinal symptoms and general malaise. During this period, the most common symptoms are neck stiffness, difficulty in concentration, and fatigue, while sensitivity to light, irritability, pallor, and nausea are also observed. Studies have shown that 68-81% of migraine patients have postdrome symptoms.