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Related Experiment Videos

Chronic daily headaches in children.

Andrew D Hershey1

  • 1Headache Centre, Division of Neurology, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. Andrew.Hershey@cchmc.org

Expert Opinion on Pharmacotherapy
|April 2, 2003
PubMed
Summary

Chronic daily headaches (CDH) are a growing concern, affecting up to 4% of adults. While the prevalence in children is unknown, most cases appear migraine-related, prompting proposed updates to diagnostic criteria.

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Area of Science:

  • Neurology
  • Pediatric Neurology
  • Headache Medicine

Background:

  • Chronic daily headache (CDH) is an increasing health concern, with adult prevalence estimated up to 4%.
  • The prevalence and specific characteristics of CDH in children remain largely undetermined.
  • Current International Headache Society (IHS) criteria primarily recognize chronic tension-type and cluster headaches as CDH.

Purpose of the Study:

  • To review the current understanding of chronic daily headaches (CDH) in children.
  • To highlight the proposed inclusion of chronic migraine in CDH diagnostic criteria.
  • To emphasize the importance of comprehensive evaluation and multi-tiered management strategies for pediatric CDH.

Main Methods:

  • Literature review of existing studies and proposed diagnostic criteria for CDH.
  • Analysis of the characteristics of CDH in pediatric populations.
  • Discussion of diagnostic evaluation, including differentiation from secondary headaches.
  • Overview of current and proposed treatment approaches for CDH.

Main Results:

  • The actual prevalence of CDH in children has not been definitively established.
  • Migraine appears to be the predominant underlying condition in the majority of pediatric CDH cases.
  • Proposed revisions to IHS criteria aim to include chronic migraine within the definition of CDH.
  • A multi-tiered management approach is recommended, incorporating abortive and prophylactic therapies, alongside behavioral interventions.

Conclusions:

  • Accurate diagnosis of pediatric CDH requires thorough history taking and physical examination to rule out secondary causes.
  • Management strategies for pediatric CDH should be individualized, focusing on reducing headache frequency and severity.
  • The evolving diagnostic criteria for CDH, particularly the inclusion of chronic migraine, are crucial for improving pediatric headache care.

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