According to the ICHD-II criteria, migraine symptoms include nausea, vomiting, phonophobia, and photophobia. Outside of these criteria, other symptoms have been reported, including sinus pain/pressure and neck pain/discomfort in adults. Prior to a new study by Hershey et al. it was unknown whether these additional symptoms were commonly associated with migraine in adolescents. For the study 656 adolescents ages 12-17 years with a history of migraines were evaluated over a 12 month period. The subjects were split into two groups by age, one 12-14 years group and one 15-17 years group. Subjects were asked to use electronic diaries to report if they experienced nausea, vomiting, photophobia, phonophobia, and sinus or neck pains. A total of 8510 migraine attacks were reported in the study, with sinus symptoms reported in 29% of the attacks and neck symptoms reported in 42% of the attacks. By age group, the incidences of both sinus and neck pain were higher in the older age group. Both sinus and neck pain were reported more frequently than vomiting during the study, and the incidence of neck pain was similar to that of nausea. Although photophobia and phonophobia were the most commonly reported migraine-associated symptoms, sinus and neck pain were reported in 30-40% of attacks, a significant percentage. Although not currently a part of the ICHD-II diagnostic criterion, due to their high incidence in this study, the researchers propose that neck and sinus pain should be considered in classification of migraine.
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