BACKGROUND Early starting of migraine seems predictive for less favorable outcome in later ages, however follow-up investigations are very few and all with short-term prospective period. We report here the longest follow-up study in a population of children presenting with migraine under the age of 6. METHODS We followed-up 74 children under 6 years of age, referred for headache to our department between 1997 and 2003. The study was carried out between October 2016 and March 2018. Headache diagnoses were made according to the IHS criteria. RESULTS 23/74 patients, 31% of the original cohort, were found at follow-up in a period ranging between 15 to 21 years after the first visit. Seven of them were headache free. The remaining 16 patients had migraine. In the migraine group, the localization of pain changed in 75% of the subjects, 11/16 (68.7%) had allodynia and 9/16 (56.25%) had cranial autonomic symptoms. CONCLUSIONS Our results suggest that the onset of migraine at very young age represents unfavorable prognostic factor for persistence of the disease at later ages. Some clinical features may change during clinical course, and the active persistence of the disorder may lead to an increase in allodynia.

中文翻译：

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6 岁以下儿童的偏头痛：一项长期随访研究

背景偏头痛的早期开始似乎预示着晚年的不良结果，但是后续调查非常少，而且都是短期的前瞻性调查。我们在此报告对 6 岁以下偏头痛儿童进行的最长随访研究。 方法 我们对 1997 年至 2003 年因头痛转诊至我们科室的 74 名 6 岁以下儿童进行了随访。该研究是2016 年 10 月至 2018 年 3 月期间进行。根据 IHS 标准进行头痛诊断。结果 23/74 名患者（占原始队列的 31%）在首次访问后的 15 至 21 年期间进行了随访。其中七人没有头痛。其余 16 名患者患有偏头痛。在偏头痛组中，75% 的受试者疼痛部位发生了变化，11/16 (68. 7%) 有异常性疼痛，9/16 (56.25%) 有颅自主神经症状。结论 我们的研究结果表明，偏头痛在很小的时候就开始出现，这是该疾病在后期持续存在的不利预后因素。一些临床特征在临床过程中可能会发生变化，并且该疾病的活跃持续存在可能导致异常性疼痛的增加。