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New daily persistent headache in the paediatric population
E Kung1, S J Tepper, A M Rapoport
1Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Insights
New daily persistent headaches (NDPH) are common in children and adolescents with chronic daily headaches (CDH). Most patients do not overuse medication, and migraine features are frequently observed in these cases.
Area of Science:
- Neurology
- Pediatrics
- Headache Medicine
Background:
- Chronic daily headaches (CDH) pose a significant challenge in pediatric populations.
- Understanding the specific clinical features of new-onset CDH is crucial for effective management.
Purpose of the Study:
- To describe the clinical characteristics of new-onset chronic daily headaches (CDH) in children and adolescents.
- To investigate the prevalence of medication overuse and migraine features in this cohort.
Main Methods:
- A clinic-based study reviewed clinical records and headache diaries of 306 children and adolescents.
- 187 individuals with CDH were identified and analyzed using modified ICHD-2 criteria for new daily persistent headaches (NDPH).
Main Results:
- New daily persistent headaches (NDPH) were common in children and adolescents with CDH.
- Most patients (91.8%) with NDPH did not overuse medication.
- Migraine features were present in individuals with NDPH on an average of 18.5 days per month.
Conclusions:
- New daily persistent headaches (NDPH) are a frequent diagnosis in pediatric CDH.
- Medication overuse is uncommon in pediatric NDPH.
- Migraine features are a common comorbidity in pediatric NDPH.
Abstract:
We conducted a clinic-based study focusing on the clinical features of new-onset chronic daily headaches (CDH) in children and adolescents. The clinical records and headache diaries of 306 children and adolescents were reviewed, to identify 187 with CDH. Relevant information was transferred to a standardized form that included operational criteria for the diagnoses of the headaches. Since we were interested in describing the clinical features of these headaches, we followed the criteria A and B of the 2nd edn of the International Classification of Headache Disorders (ICHD-2) and refer to them as new daily persistent headaches (NDPH) regardless of the presence of migraine features (therefore, this is a modified version of the ICHD-2 criteria). From the 56 adolescents with NDPH, most (91.8%) did not overuse medications. Nearly half (48.1%) reported they could recall the month when their headaches started. NDPH was more common than chronic tension-type headache in both adolescents overusing and not overusing medication. Individuals with NDPH had headaches fulfilling criteria for migraine on an average of 18.5 days per month. On most days, they had migraine-associated symptoms (one of nausea, photophobia or phonophobia)). NDPH is common in children and adolescents with CDH. Most subjects do not overuse medication. Migraine features are common.
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