The prevalence and evolution over 5 years of migraine without aura (MWOA) and migraineous disorder (MD) in 64 adolescent patients (34 girls and 30 boys, mean age 17.3 +/-1.1 years) were studied at the Institute of Neuropsychiatry, University of Palermo, Italy. Thirty two (50%) had MWOA, 18 (28.1%) had MD, and 14 (21.9%) had headache not classifiable (HnC). MWOA persisted in 56.2%, converted to MD or HnC in 9.4% and 3.1% cases, respectively, changed to episodic tension-type headache (ETTH) in 12.5%, and remitted in 18.8%. MD persisted in 11.1%, converted to MWOA or HnC in 27.8% and 5.5% cases, respectively, changed to ETTH in 11.1%, and remitted in 44.5%. Analgesic drug-use was greater in patients with MWOA than MD (80% cf 37.5%, p= .02).