The Profile and Prognosis of Youth with Status Migrainosus: Results From an Observational Study
Serena Orr1, Abigail Turner2, Marielle Kabbouche3, Paul Horn4, Hope O'Brien6, Joanne Kacperski4, Susan Lecates5, Shannon White5, Jessica Weberding4, Mimi Miller5, Scott Powers7, Andrew Hershey8
1Alberta Children'S Hospital, 2Cincinnati Children'S Hospital Medical C, 3Cincinnati Children's Hosp Medl Ctr, 4Cincinnati Children's Hospital Medical Center, 5Neurology, Cincinnati Children's Hospital Medical Center, 6Cincinnati Children'S Hospital Medical Center, 7Cincinnati Children's Hospital, 8Cincinnati Childrens Hospital Medical Center
Objective:
To characterize the clinical features of a large sample of children, adolescents and young adults with a history of status migrainosus and to describe their short-term prognosis.
Background:

Data on the clinical characteristics of children and adolescents with status migrainosus are sparse and little is known about the prognosis of this population.

Design/Methods:

Patients from the Cincinnati Children’s Hospital Headache Center were included if they had a diagnosis of migraine and data available for a 1-3 month follow-up interval. Data extracted from the initial interval visit (visit A) included: age, sex, race, migraine diagnosis, status migrainosus (SM) history, chronic migraine, medication overuse headache (MOH), BMI, headache frequency, headache severity, disability, allodynia and lifestyle habits: caffeine intake, meal skipping, sleep duration, exercise frequency and fluid intake. Data extracted from the initial consultation visit included: months with headache at initial consultation visit, patient endorsing “feeling depressed” and anxiety symptoms. Headache frequency and visit type were also measured at the second visit (visit B) in the follow-up interval.

Results:

A total of 5,316 youth with migraine were included and 559 (10.5%) had a history of SM. In the multivariate logistic regression model, predictors significantly associated with SM were: older age, female, White, migraine with aura, MOH, higher headache severity, higher disability and months with headache at initial consultation. Patients with a history of SM were more likely to experience an increase in 4 or more headache days per month at follow-up: 15.2% as compared to 11.1% of those without SM, c2 (1, n=5,316)=8.172, p=0.0043.

Conclusions:
Youth with status migrainosus represent a distinct subgroup of the migraine population and have an unfavorable short-term prognosis.