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Chronic paroxysmal hemicrania-like headaches in a child: response to a headache diary
1Division of Neurology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
A headache diary helped diagnose and treat a child with chronic paroxysmal hemicrania (CPH)-like headaches, which were triggered by stress. This non-pharmacological approach shows promise for pediatric headache management.
Area of Science:
- Neurology
- Pediatrics
- Headache Medicine
Background:
- Chronic paroxysmal hemicrania (CPH) and cluster headaches are severe unilateral headaches with autonomic dysfunction.
- While rare, both conditions can manifest in childhood.
- Distinguishing features include headache frequency, duration, and response to medication.
Observation:
- A 6-year-old boy experienced CPH-like headaches.
- Headaches were noted to occur after stressful events.
- Headache symptoms improved shortly after implementing a headache diary.
Findings:
- This is the first reported case of stress-induced CPH-like headaches in a child.
- Headache diary use correlated with symptom resolution.
- Stress as a trigger for CPH-like headaches in pediatric patients is newly identified.
Implications:
- Headache diaries can aid in diagnosing pediatric headache disorders.
- A headache diary serves as an initial non-pharmacological intervention for children.
- This case highlights the importance of considering stress in pediatric headache etiology.
Abstract:
Chronic paroxysmal hemicrania and cluster headache are both characterized by recurrent, severe, unilateral headaches accompanied by symptoms and signs of autonomic dysfunction. They are differentiated by the frequency, duration, and medication responsiveness of the headaches. Both occur in childhood, although such reports are rare. A 6-year-old boy presented with chronic paroxysmal hemicrania-like headaches. Through the use of a headache diary, his headaches were found to follow stressful events and resolved shortly after the introduction of the diary. Precipitation of chronic paroxysmal hemicrania-like headaches by stress has not been previously reported. We recommend the use of a headache diary as both an aid to diagnosis and an initial nonpharmacological therapeutic intervention for children with such headaches.