Childhood and adolescent migraine: a neuropsychiatric disorder?

Migraine is a neurological disorder characterized by unilateral head pain, nausea and/or vomiting and
altered sensory perception (particularly phono- and/or photophobia). It is a common and disabling condition
in children and adolescents, just as it is in adults; its origins, pathophysiology and long-term course
are still not fully understood.
Biological factors are currently held to be crucial in the aetiopathogenesis of primary headaches, such
as migraine. In children and adolescents, we hypothesize that for migraine to develop, life events and
their psychological processing are fundamental and can act in two different ways: either as a predisposing
factor, inducing a chronic state of anxiety or depression (even subclinical), or as a trigger factor, activating
a cascade of psychological events which, in turn, activate the biological mechanisms that produce
the migraine attack. According to our hypothesis, psychological processing of life events (i.e. how the
child perceives and mentally processes them) is the main factor in migraine aetiopathogenesis. This
hypothesis has important implications in terms of diagnostic and therapeutic choices for children and
adolescents with migraine