Purpose of review

Despite the accumulation of a significant amount of data on pediatric headache, few studies have been conducted on its occurrence in children under 7 years of age. Within primary headaches in this age, migraine especially, turns out to be a disorder affecting up to 4% of the general population. An underestimate of its true prevalence can be due to lack of specific diagnostic markers, the frequent difficulty of describing pain in childhood, and the necessity of reliable parents’ reports. Thus, migraine in children under 7 years of age represents an important challenge for clinicians. The objective of this manuscript is to provide a comprehensive review of epidemiologic, clinic, and therapeutic aspects of migraine in this age.

Recent findings

Current literature data show that migraine has some differences, especially in clinical and therapeutic terms, in this age group compared to subsequent ages. Furthermore, some evidences showing that an early onset of migraine may play an unfavorable role in its natural history, suggest an early identification and management of migraine in younger children. Moreover, we highlight the role that factors of prenatal and perinatal development can play in the predisposition and anticipation of migraine onset. Finally, open questions related to the several undefined features of migraine in this age are reported.

Summary

Migraine in this pediatric population is absolutely not rare, represents an importan clinical challenge and probably has a negative predictive role.

中文翻译：

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7 岁以下儿童的偏头痛：综述

审查目的

尽管积累了大量关于小儿头痛的数据，但很少有关于它在 7 岁以下儿童中发生的研究。在这个年龄段的原发性头痛中，尤其是偏头痛，结果证明是一种影响多达 4% 的普通人群的疾病。对其真实患病率的低估可能是由于缺乏特定的诊断标志物、描述儿童时期疼痛的频繁困难以及可靠的父母报告的必要性。因此，7 岁以下儿童的偏头痛对临床医生来说是一个重要的挑战。这份手稿的目的是对这个年龄段偏头痛的流行病学、临床和治疗方面进行全面回顾。

最近的发现

目前的文献数据表明，偏头痛在这个年龄段与后续年龄段存在一些差异，尤其是在临床和治疗方面。此外，一些证据表明偏头痛的早期发作可能对其自然病程产生不利影响，这表明对年幼儿童的偏头痛进行早期识别和管理。此外，我们强调了产前和围产期发育因素在偏头痛发作的易感性和预期中的作用。最后，报告了与这个年龄段偏头痛的几个未定义特征相关的开放性问题。

概括

偏头痛在这一儿科人群中绝非罕见，代表了一项重要的临床挑战，并且可能具有阴性预测作用。