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The prognosis of pediatric headaches--a 30-year follow-up study
Joseph M Dooley1, Haley F Augustine1, Paula M Brna1
1Department of Pediatrics, Pediatric Neurology Division, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Childhood headaches often persist into adulthood, with about 70% of individuals still experiencing them 30 years post-diagnosis. Simple management strategies like analgesia and avoiding triggers show long-term benefits for headache sufferers.
Area of Science:
- Pediatric Neurology
- Longitudinal Health Studies
Background:
- Childhood headaches are prevalent but lack extensive long-term prognosis data.
- A cohort of patients diagnosed with headaches in 1983 has been monitored for long-term outcomes.
Purpose of the Study:
- To investigate the long-term prognosis of headaches in children.
- To analyze headache characteristics and effective management strategies over 30 years.
Main Methods:
- A 30-year follow-up study involving 28 of 60 initial patients (47% participation).
- Data collected via standardized telephone interviews, gathering details on headache patterns, triggers, relief factors, and management techniques.
Main Results:
- Complete headache resolution was reported by 29% of patients over 30 years.
- Headache types varied significantly over time; only 3 patients maintained the same type.
- Nonprescription analgesia, trigger avoidance, and self-relaxation were the most common management strategies.
Conclusions:
- Approximately 70% of childhood headaches persist 30 years after initial diagnosis.
- Management through simple analgesia and precipitant avoidance demonstrates long-term efficacy.
Background:
Although headaches in childhood are common, there are few data available on their long-term prognosis. We have monitored a group of patients since diagnosis in 1983.
Methods:
Patients who were part of the 20-year follow-up study in 2003 were contacted, and data were collected using a standardized telephone interview. Details of headache characteristics and identified precipitants and alleviating factors were gathered. The most effective means of controlling the headaches were also recorded.
Results:
Follow-up was achieved for 28 of 60 patients (47%). Over the 30 years since diagnosis, eight patients (29%) reported a complete resolution of headaches, including three whose headaches resolved between the 20- and 30-year follow-up studies. The type of headache varied over the 30-year time interval with only three patients maintaining the same headache type at all four time periods of 1983, 1993, 2003, and 2013. Only one patient used prescription medication as the primary method for controlling headaches. The most commonly used intervention was nonprescription analgesia, self-relaxation and/or hypnosis, and precipitant avoidance.
Conclusions:
Headaches persist in approximately 70% of children 30 years after diagnosis. Encouraging children to manage their headaches with simple analgesia and precipitant avoidance appears to have long-term benefits.
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