الفهرس 
Definition and epidemiologyOnly 14 pages are availabe for public view
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Abstract
Migraine is one of the most common causes of primary headaches in
childhood (Bhatia et al., 2008). It may be associated with migraine
equivalents (Gelfand, 2013), but the presence of comorbid psychiatric or
behavioral disorders in this age group has not yet been well defined
(Minen et al., 2016).
Inflammation plays a significant role in the migraine
pathophysiology and recently lower serum bilirubin concentration has been
found in migraine patients in many studies (Eising et al., 2013).
Whilst the diagnosis of migraine will always be based on the
patient’s history, physical examination and electrophysiological studies
should also be assessed especially in cases with atypical symptoms or in
case of suspicion of epileptic etiology.
Our thesis was done to study the headache features of migraine in
migrainous children and adolescents, its association with migraine
equivalents (either in the past history preceding the development of
headache attacks or coexisting now with headache attacks), psychiatric
comorbidity or abnormal EEG findings in comparison to a control group of
children and adolescents without migraine or any other type of headache.
Our study was conducted on 40 patients (children and adolescents)
diagnosed with migraine according to the ICHD 3
rd edition, beta version
and not complaining from any other type of headache, compared to another
40 control subjects (also children and adolescents not complaining of
migraine or any other types of headache).
In our study we found that all studied patients had episodic migraine
and no one was diagnosed with chronic migraine. Most of them had
migraine without aura (75%). Photophobia was the most common associated symptom (60%), and vomiting was the least common one
(22.5%).
Most of the children had low frequency episodes (55%) and pain
rating indicated that most patients described pain as being severe (55%).
We reported migraine equivalents in only 15% (6/40) of the
migraine group. 4 patients complained of abdominal migraine (10%), 1
patient complained of benign paroxysmal vertigo (2.5%), and also only 1
patient complained of cyclical vomiting (2.5%).
We found statistically significant correlation between the presence
of migraine equivalents and the absence of photophobia. We didn’t find
any statistically significant correlation between the presence or absence of
migraine equivalents neither with the frequency of episodes nor with the
intensity of pain.
Migrainous children and adolescents were highly statistically
significant associated with comorbid psychiatric disorders when compared
to the controls. Anxiety was the most commonly observed disorder (in 25%
of migraine group and 38.5% of all comorbid psychiatric disorders).
As for EEG findings, we found that the rate of EEG abnormalities in
the migraine group during headache attacks (14/40 = 35%) was
significantly higher than in the control group (2/40 = 5%). Moreover, in
patients with migraine, EEG abnormalities during headache attacks were
significantly higher (14/40) than during headache-free periods (5/40). But
after the resolution of headache, there was no statistically significant
difference in the rate of EEG abnormalities between the migraine group
(5/40) and the control group (2/40).
In our study, we found that serum bilirubin concentrations (total,
direct and indirect) were highly statistically significant lower in the
migraine group than in the control group.