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Paroxysmal hemicrania in children--symptoms, diagnostic criteria, therapy and outcome

M Blankenburg1, T Hechler, G Dubbel

  • 1Vodafone Foundation Institute for Children's Pain Therapy and Paediatric Palliative Care (VIKP), Clinic for Children and Adolescents Datteln, University Witten/Herdecke, Datteln, Germany. m.blankenburg@kinderklinik-datteln.de

Cephalalgia : an International Journal of Headache
|February 25, 2009
PubMed

Insights

Paroxysmal hemicrania (PH) is rare in children, but this study found it shares similar characteristics and treatment responses to indomethacin as in adults. This suggests PH may be underdiagnosed in pediatric patients.

Area of Science:

  • Neurology
  • Pediatrics
  • Pain Medicine

Background:

  • Paroxysmal hemicrania (PH) is a rare headache disorder, extensively studied in adults but with limited pediatric case reports.
  • Previous research has not prospectively investigated PH in children, leading to potential underdiagnosis and suboptimal treatment.
  • Understanding pediatric PH is crucial for accurate diagnosis and effective management in young patients.

Purpose of the Study:

  • To prospectively evaluate pediatric patients with paroxysmal hemicrania (PH).
  • To compare the clinical characteristics, autonomic symptoms, and treatment response of pediatric PH with adult PH.
  • To determine the applicability of the International Headache Society classification for PH in children.

Main Methods:

  • Prospective follow-up study of children referred to a pediatric out-patient pain clinic over 3 years.
  • Assessment included interviews and validated questionnaires to diagnose headache disorders.
  • Diagnosis of paroxysmal hemicrania (PH) and probable PH was based on established criteria.

Main Results:

  • Five children (0.8%) were diagnosed with paroxysmal hemicrania (PH) and three (0.5%) with probable PH, totaling 1.3% of chronic headache patients.
  • Pain characteristics and autonomic symptoms in pediatric PH were comparable to those observed in adult patients.
  • Children with PH showed a similar positive treatment response to indomethacin as reported for adults.

Conclusions:

  • The International Headache Society classification criteria for paroxysmal hemicrania (PH) are applicable to pediatric patients.
  • Paroxysmal hemicrania (PH) appears to be underdiagnosed in the pediatric population.
  • Increased awareness and diagnostic efforts are needed to ensure optimal treatment for children with PH.

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