Eur J Pediatr. 2022 Apr;181(4):1679-1687.doi: 10.1007/s00431-021-04368-6. Epub 2022 Jan 10.

Léa Lenglart ^# 1, Vincenzo Raieli ^# 2, Vittorio Sciruicchio ³, Caroline Caula ⁴, Giulia Vitali ⁴, Romain Guedj ^5 6, Giuseppe Quatrosi ², Daniela D'Agnano ³, Renato D'Alonzo ⁷, Thomas Moulding ⁸, Victoria Elisa Rinaldi ⁷, Luigi Titomanlio ^4 9

Author information

¹Department of Paediatric Emergency Care, DM'UP, APHP, Hôpital Robert Debré, 48 Boulevard Serrurier, Paris, 75019, France. lea.lenglart@gmail.com.

²Child Neuropsychiatry Unit, ISMEP, ARNAS Civico, Palermo, Italy.

³Children Epilepsy and EEG Centre, S. Paolo Hospital, Bari, Italy.

⁴Department of Paediatric Emergency Care, DM'UP, APHP, Hôpital Robert Debré, 48 Boulevard Serrurier, Paris, 75019, France.

⁵Department of Paediatric Emergency Care, Hôpital Armand Trousseau, APHP, Paris, 75012, France.

⁶Faculté de Médecine, UMR153, Sorbonne Université, Paris, Inserm, France.

⁷Department of Paediatrics, Ospedale S. Giovanni Battista, Foligno, 06034, Italia.

⁸Department of Specialty and Integrated Medicine, Leeds Teaching Hospitals Trust, Leeds, UK.

⁹University of Paris, HU I2D2 INSERM UMR1141, Paris, France.

Abstract

Infantile regurgitation is one of the most common discomforts in the first months of life. Infantile colic and, in older children, functional dyspepsia have been linked to migraine. To date, this is the first study to investigate a possible association between infantile regurgitation and primary headaches in children. This is a case-control study of 195 children aged 6-17 years, with primary headache (migraine, or tension type headache) in 5 European paediatric hospitals. The control group is composed of 240 same-aged children attending with minor injuries during the same period - February 1st 2020 to December 1st 2020. A structured questionnaire identified a history of infantile regurgitation and other functional gastrointestinal disorders for case and control participants. The outcome was the difference in the prevalence of infantile regurgitation among children with or without a diagnosis of primary headache. The analysis showed a significant association between infantile regurgitation and migraine (OR = 1.88, CI 95 = 1.01-3.4, p = 0.04). No association was found between infantile regurgitation and tension type headache (p = 0.33). Subgroup analysis confirmed that the association was only significant for migraine without aura (OR = 2.3, CI 95 = 1.2-4.4, p = 0.01). In a further subgroup analysis, the presence of functional dyspepsia, irritable bowel syndrome and abdominal migraine was associated with migraine without aura.

Conclusion: The presence of migraine among children aged 6-17 was associated with a history of infantile regurgitation. Additional longitudinal studies are required to confirm whether infantile regurgitation could be considered as a precursor of migraine.

What is known: • Children suffering from functional gastrointestinal disorders are more likely to be suffering from migraine and tension-type headache as well. • Children suffering from primary headache are more likely to have had infantile colic in their first six month of life.

What is new: • It is the first study to find an association between migraine and infantile regurgitation in children. • These findings could have an impact on the diagnosis and therapeutics of both migraine and infantile regurgitation.