14-30% of migraine in children is of this variety. The aura may follow premonitory symptoms and may or may not be followed by headache. 

• The aura may suggest cortical dysfunction (visual, sensory, motor, speech or language disturbance, cognitive impairment including confusion), or brainstem dysfunction (loss of consciousness, vertigo).
• Children may find it difficult to describe the aura.
• The aura is often more distressing than the headache in children.
• Visual auras are the most common (blurred vision, fortification spectra, scotomata, micropsia, macropsia, dysmorphopsia, etc.).
• Children who eventually develop migraine with aura usually present earlier than children experiencing migraine without aura.

• Preschool children with migraine may look ill with abdominal pain and vomiting relieved by sleep.
• Preschool children may exhibit pain with changes in behaviour (irritability, crying, seeking out a darkened room).
• 5-10 year-olds often have bilateral pain with abdominal cramps and vomiting. They usually sleep within an hour of onset.
• Location and intensity of headache may alter within and between attacks.
• Intensity and duration of headache increase with age and become more usually unilateral.
• A family history is common in migraine patients.

• Cyclical vomiting with migraine (periodic syndrome). This is characterised by recurrent episodes of intense vomiting occurring often at night and with complete recovery in between attacks. Girls are more affected. Stress and dietary triggers may be identified. It typically begins in toddlers and resolves by adolescence.

Hemiplegic migraine

• A dramatic presentation.
• Hemiplegia or hemiparesis may precede or accompany the less dramatic headache.
• There is usually a family history.

Migraine without aura

 Most migraine (about 80%) is of this type.

• Premonitory symptoms (changes in mood, appetite, thirst, arousal, etc.).

• Headache lasting 30 minutes to 48 hours in children. This may be the only phase of which the patient is aware. In children the pain may be bilateral and is not always throbbing or pulsating in nature.
• Accompanying symptoms occur and are prominent in children - such as, sensitivity to light (photophobia), sounds (phonophobia) and smells, gastrointestinal disturbance, tiredness, etc.
• Postdromes (fatigue, depression).

Basilar migraine

• Aura followed by dizziness, syncope and minimal headache.
• Most often seen in adolescent girls.

• Abdominal migraine. This presents typically as recurrent bouts of generalised abdominal pain associated with nausea and vomiting but no headache, followed by sleep and recovery. Typical migraines may occur separately.