Clinical features of primary headache in children: a multicentre hospital-based study in France

Area of Science:

• Pediatric Neurology
• Headache Medicine
• Clinical Epidemiology

Background:

• Primary headaches are common in children and adolescents.
• Accurate diagnosis is crucial for effective management.
• The International Classification of Headache Disorders, 2nd edn (ICHD-II) provides standardized diagnostic criteria.

Purpose of the Study:

• To assess the concordance between clinical diagnoses and ICHD-II criteria for primary headaches in pediatric patients.
• To determine the most frequent primary headache diagnoses in this population.
• To evaluate the practical utility of ICHD-II in a clinical setting.

Main Methods:

• A 6-month prospective, multicenter study involving 486 children and adolescents (mean age 9.8 years).
• Headache features were collected using a structured questionnaire.
• Diagnoses were made by investigators and compared against ICHD-II criteria.

Main Results:

• Migraine without aura was the most common diagnosis (50.8%), followed by probable migraine (14.1%) and migraine with aura (11.1%).
• Headaches were frequently bilateral (78.1%), frontal (62.4%), and pulsatile (56.1%), with associated symptoms in 84.4%.
• Good to excellent concordance (kappa > 0.6) was observed between investigator diagnoses and ICHD-II criteria for most categories.

Conclusions:

• Migraine is the predominant primary headache diagnosis in French children and adolescents.
• The ICHD-II classification system demonstrates practical usability for diagnosing primary headaches in this demographic.
• The findings support the consistent application of ICHD-II in pediatric headache evaluations.