Overview

• Spain’s pediatric neurology society reports that 7–10% of children and adolescents can have migraines, with school stress frequently triggering attacks.
• Common precipitants include disrupted sleep, fasting, dehydration, bright or flickering screens and foods such as chocolate and aged cheeses, with alcohol and excess caffeine highlighted in teens.
• Diagnosis in minors is primarily clinical by the pediatrician, with referral to a pediatric neurologist for frequent or severe episodes or if alarm signs appear such as fever, neck stiffness, persistent vomiting, visual loss or focal deficits.
• Treatment options have expanded since 2011 to include botulinum toxin injections, monoclonal antibodies and gepants, yet patient accounts describe partial relief and waning benefit between botox cycles.
• The public-health burden remains substantial, with more than 1.5 million Spaniards living with chronic migraine and Argentine data estimating over 4 million affected with an average 11.4-year delay to accurate diagnosis.