Migraine in Iranian Children; Which Criteria Are the Best Diagnostic Criteria?

Objective

The aim of this study was to identify the best criteria for diagnosis of migraine in our pediatric population.

Materials and Methods

A total of 85 children aged below 15 years who had been referred to the Neurology Clinic of Al-Zahra Hospital with headache as their chief complaint, were enrolled. Validated questionnaires were completed by them. The patients were evaluated using five sets of diagnostic criteria including the Vahlquist, the Prensky, the International Headache Society (IHS), the IHS-Revised (IHS-R), and the Maytal criteria; the sensitivity of each set of criteria was assessed.

Results

Of the 85 children, clinically diagnosed as having migraine, 61 (72%), 73 (86%), 75 (88%), 76 (89.5%), and 76 (89.5%) met the criteria of IHS, Vahlquist, Prensky, IHS-R, and Maytal, respectively. Both the IHS-R and Maytal criteria had the highest, while the IHS criteria had the lowest sensitivity. Fifty-four children (63.5%) were positive for all five sets of criteria. The application of IHS criteria for diagnosing pediatric migraine led to a smaller percentage of children with migraine being identified.

Conclusion

Assessment of the sensitivity of the five sets of criteria for the diagnosis of migraine revealed the inadequacies and limitations of the IHS criteria in the diagnosis of pediatric migraine.