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A Single Institution's Experience of Primary Headache in Children With Celiac Disease
Grant L Hom1,2, Brian L Hom2,3, Barbara Kaplan4
1Case Western Reserve University, Cleveland, OH, USA.
Insights
Children with celiac disease frequently experience recurrent headaches. A gluten-free diet significantly improved headache frequency and intensity in many pediatric patients diagnosed with celiac disease.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Celiac Disease Research
Background:
- Limited research exists on primary headache frequency in pediatric celiac disease.
- The impact of a gluten-free diet on headache symptoms in children with celiac disease is understudied.
Purpose of the Study:
- To investigate the characteristics and frequency of headaches in children diagnosed with celiac disease.
- To evaluate the effectiveness of a gluten-free diet in alleviating headache symptoms in this population.
Main Methods:
- Retrospective review of medical records for pediatric celiac disease patients.
- Phone surveys conducted with eligible participants to gather headache history.
- Headache classification based on International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria.
Main Results:
- 39% of pediatric celiac disease patients reported recurrent headaches (≥1 per month).
- Migraine (25%) and tension-type headaches (22%) were common headache types.
- 68.75% of participants experienced reduced headache frequency or intensity after initiating a gluten-free diet.
Conclusions:
- Recurrent headaches are prevalent in approximately one-third of children and adolescents with celiac disease at diagnosis.
- A gluten-free diet demonstrates a significant positive impact on headache symptomology in pediatric celiac disease patients.
Background:
Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution.
Methods:
Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria.
Results:
247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet.
Conclusion:
This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.
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