Epidemiology

Rarely diagnosed in children under 2 years of age because of the symptom-based definition, but increases steadily with age thereafter.[1][3][4] 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][6] It occurs in equal proportions of boys and girls before puberty, but becomes predominantly female (3:1) thereafter.[7][8] The symptom-based definition precludes diagnosis in very young children.[5][6] There is some evidence that prevalence has increased over the past 30 years,[9] 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] 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] In the US, prevalence is approximately 4% to 7%.[12] Studies in developed countries suggest that migraine is the most common diagnosis among children presenting with headache to a medical practitioner.[13]

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