PURPOSE: This study was undertaken to investigate the therapeutic effects of topiramate on pediatric patients with migraine, especially migraine accompanied by aura. METHODS: From January. 2004 to December. 2006, we reviewed the medical records of 27 patients who were diagnosed as migraine and treated with topiramate. And we analysed to see whether there was any improvement of symptoms based on the migraine criteria by International Headache Society. RESULTS: There was a correlation between the migraine criteria and the improvement of symptoms after the treatment by topiramate. The symptoms of nausea, vomiting and hypersensitivity to light and sound were not associated with the improvement of symptoms after the treatment by topiramate. The symptom of aura was related with the improvement of symptoms, moreover, closely related with disappearance of symptoms after the treatment by topiramate. CONCLUSION: It is estimated that more accurate diagnosis coupled with the presence of aura is a condition to improve the treatment effects of topiramate.