Researchers at the Glia Institute, Brazil; Albert Einstein College of Medicine, NY; and other centers conducted a population-based study of school performance in children in Brazil with migraine. Episodic migraine occurred in 9%, probable migraine in 17.6%, and chronic migraine in 0.6% of 5, 671 children from 87 cities and 18 Brazilian states. Teachers provided information and measurements of the overall scholastic achievement for the school year. Parents were interviewed using a headache questionnaire and the Strengths and Difficulties Behavior Questionnaire. Poor performance in school was significantly more likely in children with episodic and chronic migraine, in terms of severity and duration of attacks, abnormal scores of mental health, and by nausea, headache frequency, use of analgesics, and gender. 
COMMENT. Children with migraine are more likely to have below average school performance relative to children without headaches and more likely to have missed school days. These associations are correlated with the severity of pain, presence of associated symptoms, and frequency of pain. The associations are predicted by behavior and emotional symptoms.
A current study to assess cognitive functioning of Italian children with migraine without aura and those with tension-type headache finds no difference in FS IQ between the groups, but children with tension-type headache have a lower verbal IQ and a higher performance IQ than healthy controls and children with migraine. Children with migraine have lower perceptual organization than those affected by tension-type headache.