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Published on: June 2, 2014
Changing headache from preschool age to puberty. A controlled study
R Virtanen1, M Aromaa, P Rautava
1Department of Public Health, University of Turku, Turku, Finland. ruut.virtanen@utu.fi
Insights
Childhood headaches, including migraine and tension-type headache, often evolve. Early headache types in children can predict migraine in puberty, with changes in symptoms and pain location over time.
Area of Science:
- Neurology
- Pediatrics
- Epidemiology
Background:
- Primary headaches are common in childhood.
- Understanding headache evolution is crucial for diagnosis and management.
- Longitudinal studies are needed to track headache progression.
Purpose of the Study:
- To investigate the natural course of primary headaches in children.
- To identify changes in headache types and associated symptoms from childhood to puberty.
- To explore the predictive value of early headache manifestations for later headache types.
Main Methods:
- A population-based cohort study involving 1132 Finnish families.
- Questionnaires administered to families of 6-year-old children.
- Clinical examinations of children with and without headaches at ages 6 and 13.
Main Results:
- Migraine in childhood evolved into tension-type headache in 32% of cases.
- Tension-type headache in childhood transformed into migraine in 38% of cases.
- Headache location shifted from supraorbital to temporal, and associated symptoms like photophobia and dizziness increased by puberty.
Conclusions:
- Headache types in children are dynamic and can change significantly by puberty.
- Early diagnosis of childhood headaches is important as they can evolve.
- The study highlights the changing nature of pediatric headaches and associated symptoms over time.
Abstract:
The characteristics of disturbing primary headache and the occurrence of headache types were studied by sending a questionnaire to 1132 Finnish families of 6-year-old children. Children with headache in the preceding 6 months and their controls were clinically examined at the ages of 6 and 13. During the follow-up, half of the headaches, classified as migraine at age 6 years, were unchanged and 32% turned into tension-type headache. In children with tension-type headache, the situation was unchanged in 35%, and in 38% of children the headache type had changed to migraine. At preschool age the most common location of headache was bilateral and supraorbital, and at puberty bilateral and temporal. During the follow-up, symptoms concurrent with headache, such as odour phobia, dizziness and balance disturbances became more typical, whereas restlessness, flushing and abdominal symptoms became less marked. The early manifestation of both migraine and tension-type headache predict equally often migraine in puberty with marked changes in concurrent symptoms and pain localization.
