Case Report: Ehlers-Danlos Syndrome in an adolescent presenting with Chronic Daily Headache

Classic Ehlers-Danlos syndrome (EDS) is a connective tissue disorder characterized by skin hyperextensibility, skin fragility as well as joint hypermobility. EDS has been associated with psychiatric disorders, fatigue, dizziness, musculoskeletal pain, and stomach pain that are common complaints associated with adolescent chronic daily headache (CDH). This case report discusses an adolescent who presents with CDH and is subsequently diagnosed with EDS based upon the presenting symptoms for headache including syncope and chronic musculoskeletal pain as well as a history of hypermobility.

A 15-year-old female presented to an outpatient headache clinic with a 10-year history of headache, which had become daily over the past 3 months and awakened her in the middle of the night. Past history also revealed chronic musculoskeletal pain, syncope, fatigue, and hypermobility of joints. Subsequent referral to a geneticist confirmed mild classic EDS.

Along with the major manifestation of EDS, other signs and symptoms that characterize this disorder include musculoskeletal pain, fatigue, dizziness/vertigo, depression, and anxiety, which are often associated with CDH in adolescents. Clinicians treating CDH need to be aware of the major clinical manifestations of EDS as well as the other signs and symptoms that characterize both of these chronic pain disorders. An understanding of this syndrome will lead not only to a diagnosis of EDS but also initiation of a treatment plan specific for an adolescent with CDH and EDS.