All forms of migraine occur in childhood. Cluster is quite rare in children, but as visitors to my website have recently pointed out it does occur. 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%.161,162 It is probable that most migrainous episodes actually begin early in childhood,{163,164} but the diagnosis is not often made until the child is old enough to describe the symptoms. Holguin and Fenichel{165} 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 al{166} 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. Golden{167} 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. Of particular note in the description above is the Distortion of Time "I was going too fast." Temporal distortions, both transient global amnesia and Time Sampling in which the perception is of speeded up time are characteristic of basilar migraine.  These concepts will be discussed in a paper to be published on this website entitled Basilar Artery Migraine (BAM) Distortions of Temporal Perception. Migraine may be triggered by head trauma in children{168} and some of the posttraumatic syndromes may be related to migraine. The suggestion has been made that transient blindness following head injury in childhood{169} may occur primarily in children with a history of migraine.{170} Acute confusional states in juveniles may also represent migraine.{132} The treatment of childhood migraine is similar to that of adult migraine (see Therapy) and is theoretically directed toward preventing vascular dilatation.{171} The prognosis in childhood migraine is thought to be good,{172} but a complete follow-up study has not been reported.{165}