Quatre syndromes périodiques de l’enfance figurent dans la seconde édition de la classification de l’International Headache Society, où ils sont reconnus comme des « précurseurs de la migraine ». Ils se manifestent par des accès épisodiques entre lesquels l’enfant est en parfaite santé. Le torticolis paroxystique bénin débute entre deux et huit mois par des accès récurrents de dystonie cervicale responsable d’une inclinaison latérale de la tête. Le vertige paroxystique bénin s’exprime par des épisodes à début brutal de vertige, durant de quelques secondes à quelques minutes, entre les âges de deux et quatre ans. Les accès du syndrome des vomissements cycliques, qui débute en moyenne vers cinq ans, sont remarquables par l’intensité des vomissements, qui retentissent notablement sur la qualité de vie de l’enfant. La migraine abdominale débute en moyenne vers sept ans et s’exprime par des épisodes de douleurs abdominales sans céphalées. Les critères diagnostiques et les recommandations publiées par l’International Headache Society et la Société nord-américaine de gastroentérologie, hépatologie et nutrition pédiatrique ont facilité la démarche diagnostique et la prise en charge thérapeutique, qui comprend la réassurance de l’enfant et des parents, des règles d’hygiène de vie, ainsi qu’un traitement antimigraineux de crise et de fond.

This review focuses on the so-called “periodic syndromes of childhood that are precursors to migraine”, as included in the Second Edition of the International Classification of Headache Disorders. Three periodic syndromes of childhood are included in the Second Edition of the International Classification of Headache Disorders: abdominal migraine, cyclic vomiting syndrome and benign paroxysmal vertigo, and a fourth, benign paroxysmal torticollis is presented in the Appendix. The key clinical features of this group of disorders are the episodic pattern and intervals of complete health. Episodes of benign paroxysmal torticollis begin between 2 and 8 months of age. Attacks are characterized by an abnormal inclination and/or rotation of the head to one side, due to cervical dystonia. They usually resolve by 5 years. Benign paroxysmal vertigo presents as sudden attacks of vertigo, accompanied by inability to stand without support, and lasting seconds to minutes. Age at onset is between 2 and 4 years, and the symptoms disappear by the age of 5. Cyclic vomiting syndrome is characterized in young infants and children by repeated stereotyped episodes of pernicious vomiting, at times to the point of dehydration, and impacting quality of life. Mean age of onset is 5 years. Abdominal migraine remains a controversial issue and presents in childhood with repeated stereotyped episodes of unexplained abdominal pain, nausea and vomiting occurring in the absence of headache. Mean age of onset is 7 years. Both cyclic vomiting syndrome and abdominal migraine are noted for the absence of pathognomonic clinical features but also for the large number of other conditions to be considered in their differential diagnoses. Diagnostic criteria, such as those of the Second Edition of the International Classification of Headache Disorders and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, have made diagnostic approach and management easier. Their diagnosis is entertained after exhaustive evaluations have proved unrevealing. The recommended diagnostic approach uses a strategy of targeted testing, which may include gastrointestinal and metabolic evaluations. Therapeutic recommendations include reassurance, both of the child and parents, lifestyle changes, prophylactic therapy (e.g., cyproheptadine in children 5 years or younger and amitriptyline for those older than 5 years), and acute therapy (e.g., triptans, as abortive therapy, and 10% glucose and ondansetron for those requiring intravenous hydration).