Migraine Disability Evaluation in Indian Children by Pediatric Migraine Disability Assessment (PedMIDAS) Scale: A Prospective Observational Study
Objective:
To study clinical characteristics, severity, treatment response of childhood migraine using PedMIDAS scale.
Background:
Migraine is the most common cause of disabling, recurring headaches in children. In Indian children, the migraine and the disability due to migraine are understudied. Hence, we aimed to assess migraine disability using the Pediatric Migraine Disability Assessment questionnaire (PedMIDAS) tool in Indian children.
Design/Methods:
Prospective Observational study for 9 months at a tertiary care center. Consecutive patients with migraine headaches presenting to Pediatric Neurology OPD of age 4-18 years were enrolled after obtaining ethical approval. The disability due to migraine headaches and treatment response to non-pharmacological interventions and supplements (coenzymeQ, magnesium, and riboflavin} at six months follow-up was assessed with PedMIDAS questionnaire.
Results:
Of 424 patients with headaches, 88 patients were diagnosed with migraine and were enrolled. Median (IQR) age was 15 years (12-16 years). 64.7% (n=57) patients were females and 35.2% (n=31) were males. 39.7% of patients had a family history of migraine (n=35). None had papilledema or significant refractive errors. Median (IQR) BMI was 18.35 Kg/m2 (16.68-19.85). Median (IQR) ESR and CRP were 12mm/hour (7.5-18.5) and 0.31 (0.19-0.73), respectively. Baseline Median (IQR) PedMIDAS score was 15 (5-37). Based on severity grading, 29 patients had little to none, 31 had mild, 11 had moderate and 17 had severe headaches. Out of 56 children who completed 6 months follow-up, 43 children had a favorable response, and 13 children had static/poor responses. Median (IQR) PedMIDAS score for 43 children with favorable response was 12 (5-29).
Conclusions:
Early diagnosis with symptomatic control improves the overall outcome and reduction in disability. Migraine is not an uncommon diagnosis but rather an undiagnosed condition, especially in adolescents, which can be easily treated by non-pharmacological measures and lifestyle changes. PedMIDAS is an excellent tool for migraine disability evaluation and monitoring.