A clinical case of polymorphism in migraine manifestations, its relationship and evolutionary connection with episodic syndromes that may be associated with migraine
DOI:
https://doi.org/10.15574/SP.2026.1(153).163168Keywords:
migraine, episodic syndromes, children, clinicAbstract
Migraine is a genetic brain disease with complex pathogenesis, polymorphic clinical manifestation and difficulty in diagnosing in children, as it may manifest itself in them not in classical variants, but in episodic syndromes - migraine phenotypes.
Aim - to inform the medical community about atypical clinical forms of migraine associated with episodic syndromes, for their timely diagnosis and, accordingly, rational therapy.
The article presents an analysis of a clinical case involving the development of migraine and related episodic syndromes. The peculiarity of this case lies in the ability to clearly trace, over the patient’s lifetime, the evolutionary stages of the development of migraine with aura, which was preceded by episodic syndromes potentially associated with migraine. The case illustrates the clinical polymorphism of migraine progression, the diagnostic challenges, and, as a consequence, the development of complications such as status migraineurs. The importance of timely diagnosis of such conditions in children and the prospects for further research are discussed.
Conclusions. Episodic syndromes in children included in ICHD-III, in particular, cyclic vomiting syndrome, abdominal migraine, may be the first stages of migraine development. The occurrence of individual episodic syndromes in a certain age range may indicate a certain evolutionary process of migraine development. The role of early preventive treatment of these episodic syndromes on their subsequent transformation into classic migraine with aura remains unstudied.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the children's parents.
The authors declare no conflict of interest.
References
Abu-Arafeh I, Gelfand AA. (2021). The childhood migraine syndrome. Nat Rev Neurol. 17(7): 449-458. https://doi.org/10.1038/s41582-021-00497-6; PMid:34040231
Azmy DJ, Qualia CM. (2020). Review of Abdominal Migraine in Children. Gastroenterol Hepatol (N Y). 16(12): 632-639.
Frattale I, Ruscitto C, Papetti L, Ursitti F, Sforza G, Moavero R et al. (2021). Migraine and Its Equivalents: What Do They Share? A Narrative Review on Common Pathophysiological Patterns. Life (Basel). 11(12): 1392. https://doi.org/10.3390/life11121392; PMid:34947923 PMCid:PMC8705894
Hasler WL, Levinthal DJ, Tarbell SE, Adams KA, Li BUK, Issenman RM et al. (2019). Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions. Neurogastroenterol Motil. 31; Suppl 2 (Suppl 2): 13607. https://doi.org/10.1111/nmo.13607; PMid:31241816 PMCid:PMC6899706
Headache Classification Committee of the International Headache Society (IHS) (2018, Jan). The International Classification of Headache Disorders. 3rd edition. Cephalalgia. 38(1): 1-211. https://doi.org/10.1177/0333102417738202
Howells R, Abu-Arafeh I. (2022). The migraine syndrome in children. Paediatrics and Child Health. 32(10): 388-393. https://doi.org/10.1016/j.paed.2022.07.011
Kaniecki R. (2024). Migraine with brainstem aura. Handb Clin Neurol. 199: 367-379. https://doi.org/10.1016/B978-0-12-823357-3.00019-7; PMid:38307657
Karrento K, Rosen JM, Tarbell SE, Issenman RM, Gelfand AA, Gamboa H et al. (2025). North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition 2025 guidelines for management of cyclic vomiting syndrome in children. J Pediatr Gastroenterol Nutr. 80(6): 1028-1061. https://doi.org/10.1002/jpn3.70020; PMid:40223700
Xu SY, Li HJ, Huang J, Li XP, Li CX. (2021, Apr 20). Migraine with Brainstem Aura Accompanied by Disorders of Consciousness. J Pain Res. 14: 1119-1127. https://doi.org/10.2147/JPR.S305483; PMid:33907459 PMCid:PMC8068516
Youssef PE, Mack KJ. (2020). Episodic and chronic migraine in children. Dev Med Child Neurol. 62(1): 34-41. https://doi.org/10.1111/dmcn.14338; PMid:31463934
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
