A clinical case of polymorphism in migraine manifestations, its relationship and evolutionary connection with episodic syndromes that may be associated with migraine

Migraine is a genetic brain disease with complex pathogenesis, polymorphic clinical manifestation and difficulty in diagnosing in children, as it may manifest itself in them not in classical variants, but in episodic syndromes - migraine phenotypes. Aim - to inform the medical community about atypical clinical forms of migraine associated with episodic syndromes, for their timely diagnosis and, accordingly, rational therapy. The article presents an analysis of a clinical case involving the development of migraine and related episodic syndromes. The peculiarity of this case lies in the ability to clearly trace, over the patient’s lifetime, the evolutionary stages of the development of migraine with aura, which was preceded by episodic syndromes potentially associated with migraine. The case illustrates the clinical polymorphism of migraine progression, the diagnostic challenges, and, as a consequence, the development of complications such as status migraineurs. The importance of timely diagnosis of such conditions in children and the prospects for further research are discussed. Conclusions. Episodic syndromes in children included in ICHD-III, in particular, cyclic vomiting syndrome, abdominal migraine, may be the first stages of migraine development. The occurrence of individual episodic syndromes in a certain age range may indicate a certain evolutionary process of migraine development. The role of early preventive treatment of these episodic syndromes on their subsequent transformation into classic migraine with aura remains unstudied. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the children's parents. The authors declare no conflict of interest.