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Published on: June 2, 2014
Chronic daily headaches in children and adolescents
1Division of Pediatric Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA. neuropub@chw.edu
Insights
Pediatric headaches, including migraines and chronic daily headaches, require different management strategies. Comprehensive assessment of comorbidities and contributing factors is crucial for effective treatment in children and adolescents.
Area of Science:
- Pediatric Neurology
- Headache Medicine
Background:
- Headaches are a frequent complaint in pediatric neurology, affecting both episodic and chronic presentations.
- Distinguishing between episodic and chronic daily headaches is essential for appropriate patient management.
Purpose of the Study:
- To highlight the importance of differentiating headache types in pediatric patients.
- To emphasize a comprehensive approach to diagnosing and treating pediatric headaches.
Main Methods:
- Review of current classifications and treatment approaches for pediatric headaches.
- Assessment of diagnostic considerations including comorbidities and psychosocial factors.
- Evaluation of treatment strategies, including medication avoidance.
Main Results:
- Episodic and chronic daily headaches necessitate distinct clinical evaluations and treatment plans.
- Identification of comorbid conditions and contributing variables (social, emotional, medical, educational) is key.
- Medications like barbiturates and narcotics may exacerbate headaches and should be used cautiously.
Conclusions:
- Effective management of pediatric headaches requires tailored strategies based on headache type and individual patient factors.
- A holistic assessment approach, considering all aspects of a child's life, improves treatment outcomes.
- Avoiding potentially worsening medications is critical for successful headache management in children.
Abstract:
Headaches, which are common in children and adolescents, represent a significant portion of patient complaints in a child neurology practice. Patients with episodic headaches, such as migraines with interval-free periods, and patients with chronic daily headaches with very few headache-free days, are often evaluated and treated differently from each other. The evolution of the classification of chronic daily headache has aided epidemiologic efforts. The disorder can be primary or related to other neurologic or systemic conditions. Comorbid conditions should be identified, and the contributing variables in the child's social, emotional, medical, and educational arenas should be assessed. The level of disability in terms of school attendance and function can help clinicians determine to what extent and how aggressively to treat these children. Rescue medications, such as barbiturates and narcotics, which can cause worsening of headaches, should be avoided.
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