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Childhood-onset cluster headache
1Department of Neurology; Psychiatry and Pain Center; General Hospital, Linz, Austria.
Pediatric Neurology
|September 6, 2002
Summary
Cluster headache, a severe neurological disorder, can affect children. This case study highlights a 7-year-old girl whose episodic cluster headaches were successfully treated with steroids after misdiagnosis.
Area of Science:
- Neurology
- Pediatrics
Background:
- Cluster headache is a primary headache disorder with established diagnostic criteria, typically emerging in the second decade of life.
- Childhood onset cluster headaches are rare, with a prevalence of approximately 0.1%.
Observation:
- A 7-year-old female presented with daily, severe, strictly unilateral orbital attacks lasting 30 minutes, accompanied by autonomic symptoms.
- Initial misdiagnosis as psychogenic headaches occurred, with no family history of headache disorders, normal neurological exams, and negative MRI findings.
- An indomethacin test was negative.
Findings:
- The patient met the diagnostic criteria for episodic cluster headaches according to the International Headache Society.
- Daily intravenous prednisolone administration effectively terminated the cluster headache attacks within three days.
Implications:
- This case underscores the importance of considering cluster headaches in pediatric patients with severe unilateral headaches and autonomic symptoms.
- Steroid therapy, specifically intravenous prednisolone, demonstrated efficacy in treating episodic cluster headaches in a child.
- Further review of pathogenesis, clinical features, and treatment options for pediatric cluster headaches is warranted.