Rarely diagnosed in children under 2 years of age because of the symptom-based definition, but increases steadily with age thereafter.[1]Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808.
https://www.ichd-3.org
http://www.ncbi.nlm.nih.gov/pubmed/23771276?tool=bestpractice.com
[3]Goadsby PJ. To scan or not to scan in headache. BMJ. 2004 Aug 28;329(7464):469-70.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15331454
http://www.ncbi.nlm.nih.gov/pubmed/15331454?tool=bestpractice.com
[4]Migraine. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of pediatrics. 16th ed. Philadelphia, PA: Saunders; 2000:1832-34. The mean age at onset is 7.2 years for boys and 10.9 years for girls, with 20% of children experiencing their first attack before the age of 5 years.[5]Stewart WF, Linet MS, Celentano DD, et al. Age- and sex-specific incidence rates of migraine with and without visual aura. Am J Epidemiol. 1991 Nov 15;134(10):1111-20.
http://www.ncbi.nlm.nih.gov/pubmed/1746521?tool=bestpractice.com
[6]Stewart WF, Lipton RB, Celentano DD, et al. Prevalence of migraine headache in the United States. JAMA. 1992 Jan 1;267(1):64-9.
http://www.ncbi.nlm.nih.gov/pubmed/1727198?tool=bestpractice.com
It occurs in equal proportions of boys and girls before puberty, but becomes predominantly female (3:1) thereafter.[7]Mortimer MJ, Kay J, Gawkrodger DJ, et al. The prevalence of headache and migraine in atopic children: an epidemiological study in general practice. Headache. 1993 Sep;33(8):427-31.
http://www.ncbi.nlm.nih.gov/pubmed/8262782?tool=bestpractice.com
[8]Lipton RB, Silberstein SD, Stewart WF. An update on the epidemiology of migraine. Headache. 1994 Jun;34(6):319-28.
http://www.ncbi.nlm.nih.gov/pubmed/7928310?tool=bestpractice.com
The symptom-based definition precludes diagnosis in very young children.[5]Stewart WF, Linet MS, Celentano DD, et al. Age- and sex-specific incidence rates of migraine with and without visual aura. Am J Epidemiol. 1991 Nov 15;134(10):1111-20.
http://www.ncbi.nlm.nih.gov/pubmed/1746521?tool=bestpractice.com
[6]Stewart WF, Lipton RB, Celentano DD, et al. Prevalence of migraine headache in the United States. JAMA. 1992 Jan 1;267(1):64-9.
http://www.ncbi.nlm.nih.gov/pubmed/1727198?tool=bestpractice.com
There is some evidence that prevalence has increased over the past 30 years,[9]Bille BS. Migraine in school children. A study of the incidence and short-term prognosis, and a clinical, psychological and electroencephalographic comparison between children with migraine and matched controls. Acta Paediatr Suppl. 1962 May;136:1-151.
http://www.ncbi.nlm.nih.gov/pubmed/13869189?tool=bestpractice.com
and statistically 1 in 9 children is affected between the age of 5 and 15 years. There is no convincing evidence that the prevalence varies with social class.[10]Deubner DC. An epidemiologic study of migraine and headache in 10-20 year olds. Headache. 1977 Sep;17(4):173-80.
http://www.ncbi.nlm.nih.gov/pubmed/893091?tool=bestpractice.com
It currently affects an estimated 50 per 1000 school-age children in the UK and an estimated 7.8 million children in the European Union.[11]Evers S. Drug treatment of migraine in children. A comparative review. Paediatr Drugs. 1999 Jan-Mar;1(1):7-18.
http://www.ncbi.nlm.nih.gov/pubmed/10937475?tool=bestpractice.com
In the US, prevalence is approximately 4% to 7%.[12]Linet MS, Stewart WF, Celentano DD, et al. An epidemiologic study of headache among adolescents and young adults. JAMA. 1989 Apr 21;261(15):2211-6.
http://www.ncbi.nlm.nih.gov/pubmed/2926969?tool=bestpractice.com
Studies in developed countries suggest that migraine is the most common diagnosis among children presenting with headache to a medical practitioner.[13]Barnes N, Millman G, James E. Migraine headache in children. Clin Evid. 2006 Jun;(15):469-75.
http://www.ncbi.nlm.nih.gov/pubmed/16973019?tool=bestpractice.com