All forms of migraine, with the exception of cluster headache, occur in childhood.  Childhood migraine would also include the childhood periodic syndromes that may be precursors to or associated with migraine (1.5 in the IHS Classification).  Some of the periodic syndromes were discussed earlier under other varieties of migraine.  The incidence of migraine in childhood has been estimated at between 2% and 5.7%.^191,192   It is probable that most migrainous episodes actually begin early in childhood,^192,193 but the diagnosis is not often made until the child is old enough to describe the symptoms. Holguin and Fenichel¹⁹⁴ reviewed the characteristics of migraine in a group of 55 children.  They stated that the clinical picture of migraine in school‑age children is only more frequent in the child, and abdominal symptoms are often more prominent. 

The visual symptoms experienced by children may be striking. Hachinski et al¹⁹⁵ reviewed the symptomatology of 100 children with migraine.  Seventy‑seven of the 100 patients had transient visual impairment or binocular scotomas.  Total obscuration of vision was more common that hemianopia. Altitudinal or quadrantic defects were unusual but did occur. Distortions of vision such as micropsia and macropsia, inversion of vision, or alterations in the perception of motion, and even elaborate hallucinations were experienced by 16 patients.  Uniocular visual impairment occurred in  7 children. 

A particularly unusual type of migraine, with recurrent attacks of impairment of time sense, body image, and visual analysis of the environment, has been termed the 'Alice in Wonderland' syndrome.  Golden¹⁹⁶ reported 2 such children who retained a clear state of consciousness during recurrent episodes.  An excerpt from the description an 11‑year‑old girl is included:

As I started to go into Mommy's room I grabbed my door ‑‑ it felt about one foot thick in my hand.  As I went through the hall, it felt as if I was going too fast. (Like you want to stop but energy is keening up inside of you.  You feel like you're going to burst and your eyes are going to pop out ‑ like you're going to explode.) Things were going too fast.  I felt like my hands were made of tiny twigs with a little mushy flesh on the outside.  I felt like I was holding things in my hands.

Migraine may be triggered by head trauma in children¹⁹⁷ and some of the posttraumatic syndromes may be related to migraine.  The suggestion has been made that transient blindness following head injury in childhood¹⁹⁸ may occur primarily in children with a history of migraine.¹⁹⁹ Acute confusional states in juveniles may also represent migraine.¹⁵⁶ 

The treatment of childhood migraine is similar to that of adult migraine (see Therapy) and is theoretically directed toward preventing vascular dilatation.²⁰⁰ The prognosis in childhood migraine is thought to be good,²⁰¹ but a complete follow‑up study has not been reported.¹⁹⁵