The Pediatric Quality of Life Inventory (PQLI), Version 4.0 and a standardized headache assessment were completed by children and parents, in a survey of 572 consecutive patients (mean age, 11.4 +/- 3.6 years) who presented with headaches at the Cincinnati Children’s Hospital Medical Center, Ohio. Most (99%) had a clinical diagnosis of migraine, 85% met migraine diagnostic criteria of the International Headache Society, and 40% had chronic daily headaches. The PQLI score for the group (73.1 +/- 14.4) was lower than that for healthy norms (83.0 +/- 14.8) and was lowest for children with chronic daily headaches (70.5 +/- 15.5). The impairment of QOL in children with migraine was similar to that observed in children with arthritis and cancer, affecting school and emotional functioning. 
COMMENT. The prevalence of childhood migraine is estimated at about 11%, more than twice that reported in earlier studies. Environmental factors, including school, social, and family tensions, are cited as factors in the increased prevalence of migraine noted in the last decade, (see Progress in Pediatric Neurology III, PNB Publishers, 1997;ppl87-190). A similar increase in migraine prevalence is noted in adult populations. With the increased consumption of snack foods, caffeine-containing beverages, and alcohol among children and adolescents, diet as a cause or precipitant of migraine is receiving increased attention . Headaches, especially chronic daily headaches, cause a pattern of disability and impairment in quality of life similar to that in children with rheumatoid arthritis or cancer. Children with migraine report more impairment in school and emotional functioning than those with other chronic diseases.