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Circadian and Seasonal Variation of Migraine Attacks in Children


  • Stefano Soriani MD,

  • Elisa Fiumana MD,

  • Roberto Manfredini MD,

  • Benedetta Boari MD,

  • Pier Antonio Battistella MD,

  • Elisabetta Canetta MD,

  • Stefania Pedretti MD,

  • Caterina Borgna-Pignatti MD

  • From the Department of Clinical and Experimental Medicine, Pediatrics, University of Ferrara, Ferrara, Italy (Drs. Soriani, Fiumana, Pedretti, and Borgna-Pignatti); Department of Clinical and Experimental Medicine, Divisions of Pediatrics and Internal Medicine, University of Ferrara, Ferrara, Italy (Drs. Manfredini and Boari); and Department of Pediatrics, University of Padua, Padua, Italy (Drs. Battistella and Canetta).

Address all correspondence to Stefano Soriani, MD, Department of Clinical and Experimental Medicine—Pediatrics, University of Ferrara, Via Fossato di 0Mortara, 64/b, 44100 Ferrara, Italy.


Object.—To investigate the rhythmicity of migraine episodes without aura in a pediatric population.

Methods.—Time of occurrence of 2517 migraine attacks in 115 children was recorded, by means of a diary, both by hourly and monthly intervals.

Results.—A significant circadian variation, characterized by a peak in the afternoon (P < .001) and one in the early morning (P= .002) was found. A seasonal peak was also observed between November and January, while a nadir was observed in July.

Conclusions.—The clustering of attacks in the morning and midday and in autumn-winter, with a minimum frequency in July, suggests that school activities may represent an important cause of migraine.