Headaches in the young

2020 ◽  
pp. 459-469
Author(s):  
Vincenzo Guidetti ◽  
Benedetti Bellini ◽  
Andrew D. Hershey
Keyword(s):  
Children And Adolescents ◽  
Tension Type Headache ◽  
Response To Treatment ◽  
Medical Attention ◽  
Developmental Level ◽  
Health Complaint ◽  
Number Of Patients ◽  
Type Headache

This chapter will review the those aspects that are specifically related to migraine in children and adolescents. Recurrent headaches are a common health complaint for children and adolescents. When these headaches recur and are brought to medical attention, they are more frequently noted to be migraine, but there are also a significant number of patients with tension-type headache. The pathophysiology, characteristics, and response to treatment for children and adolescents can be considered to be similar to adults, with unique aspects that correlate to the developmental level of the children and the progression of their disease.

scholarly journals Global Burden of Headache Disorders in Children and Adolescents 2007–2017

2020 ◽  
Vol 18 (1) ◽  
pp. 250
Author(s):  
Matilde Leonardi ◽  
Licia Grazzi ◽  
Domenico D’Amico ◽  
Paolo Martelletti ◽  
Erika Guastafierro ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Tension Type Headache ◽  
Global Burden ◽  
Specific Information ◽  
Headache Disorders ◽  
Substantial Impact ◽  
Public Health Policies ◽  
School Activities ◽  
Type Headache ◽  
Years Lived With Disability

Headache disorders are prevalent and disabling conditions impacting on people of all ages, including children and adolescents with substantial impact on their school activities and leisure time. Our study aims to report specific information on headaches in children and adolescents based on the Global Burden of Disease (GBD) study, that provides estimates for incidence, prevalence, fatal and non-fatal outcomes. We relied on 2007 and 2017 GBD estimates for prevalence and Years Lived with Disability (YLDs) at the global level and in WHO regions. The results show that, migraine and tension-type headache (TTH) together account for 37.5% of all-cause prevalence and for 7% of all-cause YLDs. Over the past decade, prevalence rates showed a mild increase of TTH in all ages and of migraine alone for adolescents. The YLDs increased among females of all ages with some regional differences that might be connected to the unequal availability of effective acute and prophylactic treatments across world regions. GBD data support the need to promote public health policies and strategies including diagnosis, pharmacological and non-pharmacological treatments that are expected to help reduce the disability and burden associated to migraine and TTH among children and adolescents.

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.

Medication overuse headache in 787 patients admitted for inpatient treatment over a period of 32 years

Cephalalgia ◽  
2020 ◽  
Vol 40 (8) ◽  
pp. 808-817 ◽  
Author(s):  
Sabine Salhofer-Polanyi ◽  
Karin Zebenholzer ◽  
Thomas Berndl ◽  
Kastriot Kastrati ◽  
Sandra Raab ◽  
...  
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Opioid Analgesics ◽  
Tension Type Headache ◽  
P Value ◽  
Cumulative Number ◽  
Number Of Patients ◽  
Withdrawal Therapy ◽  
Type Headache ◽  
Over Time

Background Definitions of medication overuse headache have changed over time. Objective To evaluate the clinical characteristics of medication overuse headache patients admitted for inpatient withdrawal therapy over a period of 32 years. Methods We included all patients with medication overuse headache treated from 1 January 1984 to 31 December 2015. We obtained all data from the medical reports and defined three periods, P1 (1984–1993), P2 (1994–2003), and P3 (2004–2015). The p-value adjusted for multiple comparisons was set to 0.005. Results Within 32 years, a total of 787 patients accounted for 904 admissions for MOH. From P1 to P3, the proportion of patients with preexisting migraine increased from 44.3% to 53.3% (chi2 = 9.0, p = 0.01) and that with preexisting tension-type headache decreased from 47.9% to 34.6% (chi2 = 9.3, p < 0.01). The median time since onset of headache and medication overuse headache decreased from 20 to 15 years ( p < 0.001) and from 3 to 2 years ( p < 0.001). The median cumulative number of single doses decreased from 120 to 90 per month ( p = 0.002). Overuse of triptans, non-opioid analgesics, and opioids increased, whereas overuse of ergotamines decreased over time ( p < 0.001 for all tests). The use of prophylactic medication before admission increased from 8.3% to 29.9% (chi2 = 89.5, p < 0.001). Conclusion This retrospective study in a large number of patients with medication overuse headache admitted for inpatient withdrawal therapy over a period of 32 years shows a trend towards changes in the preexisting headache type, a decrease in the time since onset of headache and medication overuse headache, a decrease in the number of drug doses used per month, changes in the type of drugs overused, and an increase in, but still low rate, of prophylactic medication prior to admission.

Prevalence and characteristics of headache attributed to ingestion or inhalation of a cold stimulus (HICS): A cross-sectional study

Cephalalgia ◽  
2019 ◽  
Vol 40 (3) ◽  
pp. 299-306
Author(s):  
Torsten Kraya ◽  
Malte Schulz-Ehlbeck ◽  
Philipp Burow ◽  
Stefan Watzke ◽  
Stephan Zierz
Keyword(s):  
Rating Scale ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Cross Sectional ◽  
Cold Stimulus ◽  
Clinical Criteria ◽  
Number Of Patients ◽  
Accompanying Symptoms ◽  
Type Headache

Background Headache attributed to ingestion or inhalation of a cold stimulus (HICS), colloquially called ice-cream headache, is a common form of a primary headache in adults and children. However, previous studies on adults are limited due to the small number of patients. Furthermore, most of the subjects in previous studies had a history of other primary headaches. Methods Biographic data, clinical criteria of HICS and prevalence of primary headache were collected by a standardized questionnaire. A total of 1213 questionnaires were distributed; the return rate was 51.9% (n = 629); 618 questionnaires could be analyzed. Results In a cohort of 618 people aged between 17–63 years (females: n = 426, 68.9%), the prevalence of HICS was 51.3% (317 out of 618). There was no difference between men and women (51.3% vs. 51.6%). The duration of HICS was shorter than 30 sec in 92.7%. In the HICS group, localization of the pain was occipital in 17%. Trigemino-autonomic symptoms occurred in 22%, and visual phenomena (e.g. flickering lights, spots or lines) were reported by 18% of the HICS group. The pain intensity, but not the prevalence of HICS, was higher when tension-type headache and migraine or both were present as co-morbid primary headaches (Numeric Rating Scale (NRS) 4.58 and 6.54, p = 0.006). There was no higher risk of participants with migraine getting HICS than for those who did not have migraine (odds ratio = 1.17, 95% confidence interval (CI) 0.75–1.83; p = 0.496). Conclusion The results of this study modified the current criteria for HICS in the ICHD-3 regarding duration and localization. In addition, accompanying symptoms in about one fifth of the participants are not mentioned in the ICHD-3. Neither migraine nor tension-type headache seems to be a risk factor for HICS. However, accompanying symptoms in HICS are more frequent in subjects with another primary headache than in those without such a headache.

Diagnosis of Headache in Childhood and Adolescence: A Study in 437 Patients

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 13-21 ◽  
Author(s):  
C Wöber-Bingöl ◽  
C Wöber ◽  
A Karwautz ◽  
C Vesely ◽  
C Wagner-Ennsgraber ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Outpatient Clinic ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Childhood And Adolescence ◽  
Highly Sensitive ◽  
Ihs Criteria ◽  
Type Headache ◽  
Structured Questionnaire

We investigated whether the criteria for idiopathic headache published by the International Headache Society (IHS) are useful in childhood and adolescence and compared the diagnoses according to this classification with those of Vahlquist. We used a semi-structured questionnaire to examine a total of 437 children and adolescents referred consecutively to a headache outpatient clinic. Twenty-eight of 437 patients were excluded because of symptomatic or unclassifiable headache. Of 409 patients with idiopathic headache, 70.4% had definite migraine or tension-type headache (IHS 1.1, 1.2, 2.1, 2.2), 20.5% had a migrainous disorder (IHS 1.7) and 9.1% had headache of the tension-type not fulfilling the criteria (IHS 2.3). In the differential diagnosis of migraine and tension-type headache the intensity of pain, aggravation of headache by physical activity, nausea and vomiting were the most important features. The quality of pain, photo- and phonophobia were less helpful and location least important. The duration of migraine attacks was less than 2 h in 19.0% of the migraine patients. In general, the diagnostic criteria of migraine were highly specific but less sensitive, and those of tension-type headache highly sensitive but less specific. The agreement between IHS criteria and those of Vahlquist was marked (kappa = 0.57). We conclude that the IHS criteria are useful for classifying headache in children and adolescents referred to a headache outpatient clinic. A forthcoming modification of the IHS criteria should consider a reduction of the minimum duration of migraine attacks from 2 h to I h and should try to increase the sensitivity of the criteria for migraine and the specificity of the criteria for tension-type headache.

scholarly journals Mixed Migraine and Tension-type: A Common Cause of Recurrent Headache in Children

2004 ◽  
Vol 31 (3) ◽  
pp. 315-318 ◽  
Author(s):  
Shashi S. Seshia
Keyword(s):  
Children And Adolescents ◽  
Private Practice ◽  
Tension Type Headache ◽  
Recurrent Headache ◽  
Or Practice ◽  
Neurology Clinic ◽  
Headache Type ◽  
Canadian City ◽  
Pediatric Neurologist ◽  
Type Headache

Objective:Determine relative frequency of recurrent headache (HA) types in children and adolescents referred to a pediatric neurologist. Methods and subjects: Study design: Prospective, sequential, and observational. Setting: Private practice Pediatric Neurology Clinic in a Canadian city (Winnipeg). Patients and data collection: Information on those referred with HA between September 1998 and December 2001 was entered on data sheets. Patients were followed up for one month to four years.Results:Three hundred and twenty (69%) of 463 referred with HAhad recurrent HA. There were 172 males (54%) and 148 (46%) females. Their ages ranged from two years to 19 years (median: 11 years). They had had their HA disorder for one month to 14 years (median: two years) prior to assessment. Migraine was the main HA type in 124 (38%), tension-type headache (TTH) in 57 (18%) and mixed migraine and TTH in 101 (32%). Thus, 101 (45%) of 225 with migraine as one HAtype also had TTH.Conclusion:Tension-type headache and migraine frequently co-exist and may represent a distinct headache type, at least in children; the association will likely influence response of affected children and adolescents to specific migraine treatments in clinical trials or practice.

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