Migraine with aura: A predictor of patent foramen ovale in children and adolescents

Background: The prevalence of patent foramen ovale (PFO) is higher among adult migraine patients. The purpose of this study was to determine the frequency of PFO in children and adolescent migraine patients. Methods and results: A total of 32 patients with migraine (divided into two subgroups, the migraine with aura subgroup and the migraine without aura subgroup) and 31 normal control subjects were enrolled in this study. All of the participants underwent transthoracic echocardiography with an agitated saline test. We compared the prevalence of PFO and the severity of right-to-left shunt (RLS) in each group. No statistical difference in age and sex ratio was observed in either group. The prevalence of PFO was higher in the migraine group than in the control group, but without statistical significance (46.9% vs. 25.8%, p=0.084). The prevalence of PFO was significantly higher in the migraine with aura subgroup than in the migraine without aura subgroup (p=0.031) and the normal control group (p=0.0074). Migraine with aura was the only significant factor showing an association with PFO (≤0.01). RLS size did not have an influence on migraine. Conclusions: Considering the significantly high prevalence of PFO in pediatric migraine with aura patients, migraine with aura is a clear predictor of PFO among children and adolescents.