The characteristics of cold induced headaches in a group of migraine patients were compared with the usual migraine headaches and with cold induced headaches in a control population, in a study using a retrospective questionnaire at the City of London Migraine Clinic, London, England. The control patients were preclinical medical and dental student volunteers. Seventeen percent of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream. “Ice cream headache” was less common in migraine patients than the controls, and the pattern of the headache induced by ice cream was similar in the 2 groups. Only 2 of the 12 migraine patients who developed ice cream headache on testing experienced the headache at a similar site to their usual migraines. 
COMMENT. This study suggests that ice cream headache is common but may be less common in migraine patients than the general population. These findings are in contrast to some previous studies showing that 93% of migraine patients reported ice cream headaches compared with 31% of non headache controls. 
The precipitating factors noted in 6 of 51 Nigerian children with migraine were fatigue in 3, lack of sleep in 2, and milk chocolate drink in 1. Ice cream was not noted as migraine precipitant in this study from Kano, Nigeria . Haemoglobin genotype obtained in 41 cases was AA in 66% and AS in 34%. The prevalence of haemoglobin AS was higher than in the general population (25%).