scholarly journals Chronic Daily Headache in Children and Adolescents

2004 ◽  
Vol 31 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Shashi S. Seshia
Keyword(s):  
Children And Adolescents ◽  
Chronic Daily Headache ◽  
Specific Treatment ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Teenage Girls ◽  
Daily Headache ◽  
Type Headache ◽  
Evidenced Based

Objective:Characterize chronic daily headache in those less than 20 years of age. Material andMethods:Study design: Prospective, observational, and sequential.Setting:Private practice Pediatric Neurology Clinic in a Canadian city (Winnipeg).Patients and data collection:Data on those referred with headache between September 1998 and December 2001 were entered on data sheets. Patients were followed up for one month to four years.Results:One hundred and forty-three (31%) of 463 referred with headache had chronic daily headache with duration of one month to five years (median: eight months). The age range was 5.5 years to 20 years (median: 13 years). There were significantly more females (N=93) than males (N=50). The main groups were: (1) transformed migraine: 6 (4%), (2) transformed tension-type headache: 80 (56%) and (3) transformed comorbid migraine and tension-type headache: 39 (27%). Tension-type features dominated in 94%. Analgesia overuse occurred in two. Stressors were recognized in 60 (42%); anxiety disorder was diagnosed in 8 (6%), and depression in 13 (9%). Computed tomography scans were done in 31 (22%), and MRI/MR angiography in 8 (6%) and were normal or showed nonspecific incidental findings. Twenty-two (15%) were lost to follow-up; 115 of the remaining 121 (95%) were headache free or greatly improved, 63 (55%) without specific treatment.Conclusion:Chronic daily headache is a common headache disorder in children and adolescents, especially in teenage girls. A prospective neuropsychiatric approach is necessary for evidenced-based management, since the condition has mental health, social and economic ramifications.

Chronic Daily Headaches in Children and Adolescents

Cephalalgia ◽  
2004 ◽  
Vol 24 (6) ◽  
pp. 476-482 ◽  
Author(s):  
SB Esposito ◽  
JLD Gherpelli
Keyword(s):  
Children And Adolescents ◽  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Time Interval ◽  
Transformed Migraine ◽  
Average Intake ◽  
Daily Headache ◽  
Chronic Daily Headaches ◽  
Type Headache ◽  
Mixed Pattern

The clinical characteristics of chronic daily headache were studied in 40 children and adolescents, as well as the associated factors responsible for maintenance of the continuous headache pattern. The study of the clinical headache characteristics, showed a female preponderance (75%), mean age of 11 years old at the first consultation, and onset of headache symptomatology at a mean age of 8.5 years old. The average time interval for the evolution of sporadic headache into chronic daily headache was 1.4 years, and psychosocial stressors were present, acutely or chronically, during the period of headache-frequency increase in 47% of the children. Headaches were classified as transformed migraine (65%), mixed pattern (17.5%) and chronic tension-type headache (17.5%). Sixty per cent of patients had mothers with migraine. Data regarding common analgesic use showed an average intake of 11.2 days/month.

Chronic Tension-Type Headache in Children and Adolescents

Cephalalgia ◽  
2001 ◽  
Vol 21 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Ishaq Abu-Arafeh
Keyword(s):  
Children And Adolescents ◽  
Clinical Features ◽  
Chronic Daily Headache ◽  
Adult Population ◽  
Tension Type Headache ◽  
Stressful Events ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2: 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as ‘just sore’ or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.

An epidemiological approach to the nosography of chronic daily headache

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Giorgio Sandrini ◽  
Gian Camillo Manzoni ◽  
Carla Zanferrari ◽  
Giuseppe Nappi
Keyword(s):  
Clinical Features ◽  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Recent Classification ◽  
Type Headache ◽  
Epidemiological Approach

Chronic daily headache (CDH), a heterogeneous group of headaches, includes different forms that occur daily, or almost daily, over a prolonged period of time. The nosography of this group is still a matter of debate, and in the most recent classification of the IHS (1988) only a few types of CDH are included: chronic tension-type headache, coexisting migraine. This study is an epidemiological approach to identifying the clinical features of CDH and the possible factors involved in changing episodic headache in CDH. Ninety CDH outpatients were investigated using a computerized record chart. The main observed forms were: (a) chronic tension-type headache–migraine with interparoxysmal headache, an evolved form of migraine in which a constant low severity headache develops between attacks; (b) transformed migraine, an evolved form of migraine with progressive worsening of the disease which reaches the level of continuous pain with the disappearance of typical migraine attacks. Interval headaches in migraine with interparoxysmal headache partly fulfil the IHS criteria for chronic tension-type headache. Analgesic drug abuse plays a prominent role in inducing CDH and in determining its clinical features.

Transformed migraine

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 78-83 ◽  
Author(s):  
Ninan T Mathew
Keyword(s):  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Mixed Features ◽  
History Of ◽  
Daily Headache ◽  
International Headache Classification ◽  
Type Headache

Chronic tension-type headache, which is included in the International Headache Classification, is present in only a minority of patients who present with chronic daily headache. The majority have what is termed transformed migraine, with a history of distinct episodes of migraine in the initial years which progresses into chronic daily headache. These patients with transformed migraine exhibit mixed features of migraine and chronic tension-type headache. Two distinct types of transformed migraine are identifiable, namely those related to excessive intake of medications (drug-induced transformed migraine) and those unrelated to excessive use of medications. The clinical features of transformed migraine and the drug-induced variety are described. The need for revision of the International Classification to include chronic daily headache and the subtypes of transformed migraine is pointed out.

Contingent Negative Variation in Patients with Chronic Daily Headache

Cephalalgia ◽  
1998 ◽  
Vol 18 (8) ◽  
pp. 565-569 ◽  
Author(s):  
M Siniatchkin ◽  
W-D Gerber ◽  
P Kropp ◽  
A Vein
Keyword(s):  
Chronic Daily Headache ◽  
Contingent Negative Variation ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Early Component ◽  
Predictive Variables ◽  
Environment Control ◽  
Daily Headache ◽  
Type Headache

The aim of this study was the investigation of amplitude and habituation of contingent negative variation (CNV) in migraine and chronic daily headache (CDH) patients in order to describe possible neurophysiological features responsible for the clinical transformation and worsening of the headache. Fifteen females suffering from migraine without aura and 15 females diagnosed with CDH evolved from migraine without aura with interparoxysmal chronic tension-type headache (transformed migraine), underwent CNV recording. Fifteen healthy females matched for age served as controls. CNV was obtained from C3 and C4 using the standard reaction time paradigm and 3 sec ISI. The amplitudes and habituation of total CNV, early and late components, and of post-imperative negative variation (PINV) were calculated. The migraine patients were characterized by significantly more pronounced negativity of the early component and total CNV, compared to CDH sufferers and controls. CDH patients demonstrated significantly reduced negativity of the late component and pronounced PINV compared to the other groups. The early component of CNV did not habituate in migraine or CDH patients. However, the impaired habituation in CDH was related to significantly lower amplitudes. These results support the diagnostic and scientific value of habituation in migraine research and therapy. Late components of CNV and PINV can be considered as predictive variables for transformation of migraine. The results are discussed in terms of the relationship between late CNV, PINV, environment control abilities and susceptibility for development of depression.

A Comparison of Disability and Psychological Factors in Migraine and Transformed Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (3) ◽  
pp. 172-178 ◽  
Author(s):  
JE Magnusson ◽  
WJ Becker
Keyword(s):  
Chronic Daily Headache ◽  
Psychological Factors ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Headache Intensity ◽  
Daily Headache ◽  
Type Headache

The classification of patients with migraine who develop chronic daily headache is controversial, with some classifying such patients as ‘transformed migraine’. We compared patients with intermittent migraine attacks and patients with transformed migraine in terms of mean headache intensity on days with headache, depression, pain-related anxiety and headache-related disability. Patients classified clinically as also having tension-type headache were excluded. Aside from the number of days with headache per month, patients with intermittent migraine attacks and patients with transformed migraine were very similar in terms of all parameters studied. Our results support the concept that these two headache groups are closely related.

Chronic Daily Headache in Children and Adolescents: A Clinic Based Study from India

Cephalalgia ◽  
2005 ◽  
Vol 25 (10) ◽  
pp. 795-800 ◽  
Author(s):  
A Chakravarty
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Interpersonal Relationships ◽  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Case Definitions ◽  
Indian Children ◽  
Daily Headache ◽  
Type Headache

Chronic Daily Headache (CDH) is uncommon in Indian children compared to their adult counterpart. This is a retrospective study looking at the headache phenomenology of CDH in Indian children and adolescents. The validity of the case definitions of subtypes of chronic primary headaches mentioned in the HIS 2004 classification have been evaluated. 22 children (age range 8-15 years; M : F-16 : 6) diagnosed as having primary CDH using a modified definition seen between 2002 and 2003 have been studied. CDH has been defined as daily or near daily headaches > 15d/month for > 6 weeks. The rationale for this modified definition has been discussed. Majority of children (15/22) had a more or loss specified time of onset of regular headache spells resembling New Daily Persistent Headache (NDPH) but did not fulfil totally the diagnostic criteria of NDPH as laid down by IHS 2004. In all cases headache phenomenology included a significant vascular component. Headache phenomenology closely resembled Chronic Tension Type Headache (CTTH) in 4 patients and Chronic Migraine in 3 patients. However, in no patient in these groups, a history of evolution from the episodic forms of the diseases could be elicited. Heightened level of anxiety mostly related to academic stress and achievement was noted in the majority (19/22). Only a minority of patients (3/22) had anxiety and depression related to interpersonal relationships in the family. Medication overuse was not implicated in any patient. CDH in children in India is very much different from CDH in adults with the vast majority of patients exhibiting overlapping features of migraine and tension-type headache. There is need for a modified diagnostic criteria and terminology for chronic primary headaches in children.

scholarly journals Study of Sleep Disorders and Polysomnographic Evaluation among Primary Chronic Daily Headache Patients

2016 ◽  
Vol 07 (S 01) ◽  
pp. S072-S075 ◽  
Author(s):  
Rajesh Verma ◽  
Kamal Kumar Nagar ◽  
Ravindra Kumar Garg ◽  
Ravi Uniyal ◽  
Praveen Kumar Sharma ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Chronic Daily Headache ◽  
Daytime Sleepiness ◽  
Structured Interview ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Patients

ABSTRACT Objective: Studies related to sleep disorders and polysomnography (PSG) among chronic daily headache patients are rare. We studied this and compared chronic migraine (CM) with chronic tension-type headache. Methods: Eighty-three patients were recruited. They were evaluated by semi-structured interview, headache, and sleep diaries along with Epworth Sleepiness Scale score and insomnia symptom score. Overnight PSG was performed and data compared. Results: Chronic tension-type headache was more common than CM, both having female preponderance. Insomnia followed by excessive daytime sleepiness was prevalent sleep disorder. Sleep efficiency and Stage 3 sleep were lower in CM compared to chronic tension-type. ESSS was significantly increased among chronic tension-type patients. No significant correlation was found among PSG parameters in patients with or without sleep disorders. Conclusion: Insomnia being most common sleep disorder among chronic headache population. Chronic tension-type headache had slightly better slow-wave sleep than CM and significantly increased daytime sleepiness.

Chronic Daily Headaches: Clinical Profile in Indian Patients

Cephalalgia ◽  
2003 ◽  
Vol 23 (5) ◽  
pp. 348-355 ◽  
Author(s):  
A Chakravarty
Keyword(s):  
Present Report ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Average Dose ◽  
Transformed Migraine ◽  
History Of ◽  
Daily Headache ◽  
Therapy Withdrawal ◽  
Type Headache

Chronic daily headache (CDH) remains a relatively unexplored entity in India. Misconceptions are common, unnecessary investigations often done and inappropriate therapy prescribed. Analgesic overuse is seldom recognized. The present report appears to be the first of its kind from India. CDH has been defined as headaches occurring more than 15 days per month for more than 3 months (secondary causes excluded). Over 2 years (1998-1999) 849 cases (49.6% of all primary headaches) were seen. More than 1 year's follow-up data were available in 205 subjects (M 34; F 171). The distribution of these was as follows: (i), chronic tension-type headache (CTH), 33 (16.1%); (ii), chronic/transformed migraine (TM), 169 (82.4%); (iii), new persistent CDH, 3 (1.5%). There were 169 cases of TM (M:F 1:4.7; age 26-58 years). History of past episodic migraine was present in all. Transformation had been gradual (89.4%) or acute (10.6%). Possible factors in transformation included psychological stress (44.4%), analgesic overuse (28.4%), ergot overuse (4.1%). HRT seemed to be implicated in three female subjects. Analgesic overuse was limited between intake of 600 and 2400 mg of aspirin equivalent per day (mean 735 mg). Ergot overuse varied between 1 and 3 mg/day of ergotamine for ≥ 3 days/week. With medical therapy approximately 70% TM and 40% CTH patients noted significant improvement. About 80% of these relapsed on therapy withdrawal. CDH in India is not uncommon. Analgesic/ergot overuse needs to be recognized early. The average dose of analgesic implicated in CDH seems much less compared with that reported in the West.

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