6082 Triggers of childhood migraine

Objectives The main aim of this study is to identify triggers of acute attacks of migraine among children and young people. Methods This is an observational hospital-based clinical study. The study population consisted of consecutive patients who referred to our paediatric headache clinic. We specifically enquired about triggers that often or always trigger acute attacks of migraine. If needed, patients were asked to keep their own dairy with emphasis on stimulus or triggers of their headache. Data included epidemiological details and characteristics of migraine. Diagnosis of migraine was based on the International Classification of Headache Disorder 2013, beta version (ICHD beta version).¹ Results 1485 patients diagnosed with migraine were included in this study. Of these, 825 females (55.5%), 563 from different ethnicities (38%). Their age ranged from 2 to 17 years (Mean = 8 years). Family history of migraine identified among 799 (54.5%). Triggers were reported by 566/1485 (38%) patients. Triggers were just one (359/63.5%), two (159/28%), three (41/7%), four or more (7/1%) patients. Most common triggers were bright light (183/566, 32%), stress (147/566, 26%), loud noise (137/566, 24%), inadequate fluid intake (122/566, 21.5%), and specific food items (65/566, 11.5%). Conclusion Although there appears to be some preliminary studies on trigger factors for migraines, literature particularly among children and young people is sparse. 38% of our cohort reported specific factors that triggered the attacks of their migraine. Our data identifies bright light, stress and loud noise as the most common triggers but factors such as missing a meal or fasting do not appear to be applicable in our local young population that might reflect the generality in England. With the identification of trigger factors among children and young people with migraine, we may be able to improve the management of these patients. Avoidance of triggers could potentially be a step forward in their successful treatment and improvement of their quality of life. Hence, focused headache history must include migraine triggers. Reference Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version) Cephalalgia 2013;33:629–808.