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Pediatric mixed headache -The relationship between migraine, tension-type headache and learning disabilities - in a
Jacob Genizi1,2,3, Amal Khourieh Matar4, Mitchell Schertz5
1Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel. genizij@gmail.com.
Insights
Pediatric migraine and tension-type headaches (TTH) often overlap. Children with mixed headaches, combining migraine and TTH, show a higher incidence of learning disabilities compared to those with migraine alone.
Area of Science:
- Pediatric Neurology
- Child Psychology
Background:
- Headache is a frequent pediatric complaint.
- Migraine and tension-type headache (TTH) are common primary headache syndromes in children.
- These headache types can frequently overlap in presentation.
Purpose of the Study:
- To investigate the relationship between pediatric migraine, TTH, and learning disabilities.
- To understand the co-occurrence patterns of different headache types in children.
Main Methods:
- Assessment of 262 children (ages 5-18) diagnosed with migraine across three pediatric neurology clinics over five years.
- Data collection included headache type, demographic information, and learning disability assessment.
Main Results:
- 22.5% of children with migraine also reported symptoms of episodic TTH/mixed headaches.
- Females were significantly more likely to experience mixed headaches (OR: 2.81).
- Children with mixed headaches were 2.7 times more likely to have a learning disability than those with migraine alone.
Conclusions:
- Episodic TTH and migraine without aura (mixed headaches) may represent a continuum in children.
- The co-occurrence of migraine and TTH is more common than migraine with aura.
- Mixed headaches in children are associated with a higher prevalence of learning disabilities.
Background:
Headache is a common complaint among children. The most common primary headache syndromes in childhood are migraine and TTH. However many times they seem to overlap. The purpose of our study was to assess the relationship between pediatric migraine, tension-type headache (TTH) and learning disabilities.
Methods:
Children presenting with headache to three pediatric neurology clinics in the last 5 years were assessed. Two hundred sixty-two children, 5-18 years of age, who met the criteria for migraine were included.
Results:
Of 262 children (54 % female) who had migraine, 26.2 % had migraine with aura. 59 children (22.5 % of the full sample) reported also having headaches that met the criteria for episodic TTH/mixed headaches. Females were more than 2.8 times more likely to experience mixed headaches than males (OR: 2.81, 95 % CI: 1.43-5.54; p <.003). Multiple logistic regression analysis revealed that older age (p <0.02), family history of aura (p <.02), and (lack of) TTH (p <.003) were significant predictors of aura, whereas gender was not significant (p >0.20). Children who had migraine with aura were less likely to have mixed headaches than children who did not have aura (OR: 0.26, 95 % CI: 0.11-0.63; p <.003). Children with mixed headaches were 2.7 times more likely to have a learning disability than children with migraine alone.
Conclusions:
Episodic TTH and migraine without aura (mixed headaches) in children might be part of a continuum, which can explain the high incidence of their co-occurrence as opposed to migraine with aura. Children with mixed headaches have a higher incidence of learning disability compare to those with migraine alone.
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