Episodic Syndromes That May Be Associated With Migraine - Two Clinically Useful Markers

Objective: To document episodic syndromes that may be related to migraine (International Classification of headache disorders edition 3-beta versions, code 1.6) and to suggest two clinically useful markers for diagnosing episodic syndromes. Methods: Children and adolescents aged 3 years to 15 years presenting with recurrent head pain of definite / probable migraine origin were interviewed along with their parents or accompanying family member over a period of 2 years (October 2013 to September 2015). Present and past histories of symptoms suggestive of episodic syndromes were documented. ICHD-3 beta diagnostic criteria applied in all cases. Results: 176 fulfilled the ICHD-3 beta diagnostic criteria for episodic syndromes. Abdominal migraine in 98, brief episodes of vertigo / imbalance suggestive of benign paroxysmal vertigo were reported by 62, Cyclical vomiting in 14 and Benign paroxysmal torticollis in 2.124 (70%) were getting these symptoms when exposed to common migraine triggers in this region. Either a single trigger or combination of triggers precipitated these manifestations. 144 (88%) first or second degree siblings were suffering from migraine (1.1, 1.2, 1.5 or brief migraines). Conclusion: Episodic syndromes are not rare in daily clinical practice. Documenting Common migraine triggers and family history of migraine will make episodic syndrome diagnosis easier in children and adolescents.