Prognosis of migraine headaches in adolescents - A 10-year follow-up study

Objective: To determine the long-term outcome of migraine headaches in adolescents and to identify possible predictors of prognosis. Methods: Fifty-five of 80 subjects with migraine headaches (ages 11 to 14 years), who attended the baseline examination of a population-based study conducted in southern Italy in 1989, were eligible for follow-up in 1999. All interviews and examinations were conducted by neurologists, and migraine diagnoses were based on the International Headache Society (IHS) criteria. The association between possible prognostic factors and the long-term persistence of migraine headaches was explored using logistic regression analysis. Results: Of 55 subjects with migraine headaches at baseline, 41.8% had persistent migraine, 38.2% had experienced remission, and 20.0% transformed to tension-type headache. Only migraine without aura persisted in the same IHS code after 10 years, whereas migrainous disorder and nonclassifiable headache did not. The family history of migraine significantly predicted the 10-year persistence of migraine headaches (odds ratio [OR]=7.0; 95% CI: 1.7 to 26.8). The risk persisted when only subjects with migraine with or without aura were evaluated (OR=5.0; 95% CI: 1.2 to 20.9). Conclusions: Migraine headaches in adolescents have a favorable long-term prognosis. Familial disposition for migraine predicted a poorer outcome, especially in subjects with migraine without aura.