Objective:

To determine the prevalence and correlation of vibratory sensory deficit to migraine symptoms in pediatric patients with migraines

Background:

Based on ongoing work, we found selective vibratory sensory deficit in adults with migraines.  We explored the prevalence and correlation of this abnormality in children and teenagers with migraines during acute migraine spells.  Children suffer from similar sensory abnormalities as adults, though it is difficult to assess migraines in children and they have been less studied.

Design/Methods:

This is a 10-year chart review of our pediatric patients with migraines, age 5-17 years old.  Each patient had a complete neurologic examination.  Vibration sensation was tested in both upper and lower extremities and was compared between patient and examiner.  Often, the patient noted loss of vibration, while active vibration was still felt by the examiner.  Patients were followed serially during migraine treatment over 1-3 months.  At each visit, patients were rated with a total tuning fork (TTF) score that was the sum of time discrepancies measured at 2 different sites on each leg.

Results:

In a cohort of 318 pediatric patients, 236 show tuning fork abnormalities (74%).  Similar to our adult study, this vibratory abnormality was selective, occurring only in the lower extremities and with intact proprioception.  During acute migraine spells, the average tuning fork discrepancy was 3.5 sec. on the left ankle and 3.8 sec. on the left mid-tibia.  TTF scores averaged between 11-13 sec., with scores as high as 25.  Control TTF scores were <4 sec. Treatment with standard anti-migraine medications helped resolve migraine symptoms and decreased the tuning fork abnormality at individual sites and as measured by TTF scores.

Conclusions:

This selective vibration sensory deficit was present in a high percentage of children and teenagers with migraines.  Dynamic changes in this sensory abnormality paralleled resolving migraine symptoms during anti-migraine treatment.