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Korean J Pediatr 2009 May;52(5) :557-566.
Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II)
Jae Yong Park (Park JY)1, Sang-Ook Nam (Nam SO)2, So-Hee Eun (Eun SH)3, Su Jeong You (You SJ)4, Hoon-Chul Kang (Kang HC)4, Baik-Lin Eun (Eun BL)3, Hee Jung Chung (Chung HJ)1
1Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital
2Department of Pediatrics, Pusan National University School of Medicine
3Department of Pediatrics, Korea University College of Medicine
4Department of Pediatrics, Inje University College of Medicine
Corresponding Author: Hee Jung Chung ,Email:
Copyright © 2009 by The Korean Pediatric Society
Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was 6.33.6 yr, 8.52.7 yr, and 8.52.9 yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was 8.03.4 yr, 10.52.6 yr, and 10.13.2 yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.
Keywords: Childhood periodic syndrome | Migraine headache | Cyclic vomiting syndrome | Abdominal migraine | Benign paroxysmal vertigo of childhood
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