ABSTRACT
It has long been recognized that migraine is not merely a syndrome of headache, but that the headache is associated with a range of other symptoms. Migraine is the most common cause of headache in the prepubertal child,1 but headache is not its only manifestation. It figures prominently in the causation of periodic abdominal pain, cyclical vomiting and other aspects of the ‘periodic syndrome’, as well as in the differential diagnosis of vertigo and the less frequent clinical syndromes of complex migraine. In many cases, the associated symptoms are more prominent than the headache and often these occur in the absence of headache. These associated symptoms form several recognized clinical syndromes such as abdominal migraine and cyclical vomiting, although it is not unusual to see a degree of overlap clinically between these syndromes. The outstanding feature of migraine in any of its manifestations is its paroxysmal or periodic occurrence. There is always a return to baseline with resulting symptom-free intervals. Without this feature it is not migraine.
