Migraine is a complex genetic brain disorder with an intricate pathogenesis and polymorphous clinical presentations, particularly in children. In this Perspective, we describe the different phenotypes of migraine in children, including conditions that have been referred to in the International Classification of Headache Disorders as “syndromes that may be related to migraine’’. Evidence is presented for the integration of abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis and infantile colic into the unified diagnosis of ‘childhood migraine syndrome’ on the basis of clinical and epidemiological characteristics, and shared inheritance. In our opinion, such integration will guide clinicians from specialities other than neurology to consider migraine in the assessment of children with these disorders, as well as stimulate research into the genetics, pathophysiology and clinical features of all disorders within the syndrome. A diagnosis of childhood migraine syndrome would also enable patients to benefit from inclusion in clinical trials of old and new migraine treatments, thus potentially increasing the number of treatment options available.

偏头痛是一种复杂的遗传性脑部疾病，具有复杂的发病机制和多形的临床表现，尤其是在儿童中。在这篇《观点》中，我们描述了儿童偏头痛的不同表型，包括国际头痛疾病分类中称为“可能与偏头痛相关的综合征”的病症。根据临床和流行病学特征以及共同遗传，提供了将腹型偏头痛、周期性呕吐综合征、良性阵发性眩晕、良性阵发性斜颈和婴儿绞痛纳入“儿童偏头痛综合征”统一诊断的证据。在我们看来，这种整合将指导神经学以外专业的临床医生在评估患有这些疾病的儿童时考虑偏头痛，并促进对该综合征内所有疾病的遗传学、病理生理学和临床特征的研究。儿童偏头痛综合征的诊断也将使患者受益于纳入旧的和新的偏头痛治疗的临床试验，从而可能增加可用的治疗选择的数量。