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We report an 8\u2010year\u2010old boy with SIOD and recurrent, severe, refractory migraine\u2010like headaches. Through a retrospective questionnaire\u2010based study, we found that refractory and severely disabling migraine\u2010like headaches occur in nearly half of SIOD patients. We have also found that the vasodilator minoxidil provided symptomatic relief for one patient. 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