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Clinical
features should be routinely assessed in children with migraine as majority of children with migraine showed symptoms of
central sensitization such as allodynia and pericranial tenderness.
New research shows, children with migraines experience central sensitisation involving changes in the central nervous system, linked to pericranial tenderness and juvenile fibromyalgia. Central sensitisation includes when a patient experience increased sensitivity and feel pain with less provocation is a common by-product of a migraine attack. The clinical manifestation of central sensitisation, allodynia (pain following ordinarily nonpainful, often repetitive, stimulation) is present in 90% of chronic migraine patients and 70% of episodic migraine patients.
Large-scale studies conducted in adults with
chronic migraines have shown that allodynia is highly prevalent, along with
anxiety, depression, and disability. Moreover, recent studies conducted in
children with headaches has also demonstrated the allodynia frequency. However,
other signs of central sensitisation had not yet been assessed in children such
as pericranial tenderness or fibromyalgia comorbidity.
Iqura; M. at Bari Aldi Moro University in Italy conducted a study on children
ages 8-15 with migraines. The primary goal was to determine the prevalence of
allodynia, pericranial tenderness, and juvenile fibromyalgia in these children.
The second aim of the observation was to evaluate these severity conditions was
associated with a decreased quality of life, anxiety, pain catastrophizing,
depression, migraine-related disability, and sleep disorders. Of the 151
patients recruited, there were 92 patients with migraines without aura, 47
patients with chronic migraines, and 12 with migraines and aura. In total,
96.6% of the children reported allodynia, and the severity of allodynia was
significantly correlated with anxiety, higher disability, pain
catastrophizing, and insomnia. 68.8%
pericranial tenderness patients were prevailing and were more severe in
patients who experienced chronic migraines, and those that had insomnia. 0.03%
of children with migraines evaluated allodynia and juvenile fibromyalgia.
Patients had higher allodynia scores, experienced more depression and more
severe pericranial tenderness and in children found a significant decrease in
quality of life compared to the other patients. To the resultant, there are
multiple manifestations of migraines, such as pericranial tenderness and
fibromyalgia of central sensitisation in children. Furthermore, for juvenile
fibromyalgia children with severe allodynia and comorbidity had a significant
decrease in quality of life, which suggests routine clinical assessment of
these children to prevent the disease from progressing into a severe
disability.
The Journal of Headache and Pain.
Children with Migraines Should Be Monitored for Fibromyalgia and Other Conditions, Study Finds
Iqura M.
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