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Published on: June 2, 2014
Headache in the Pediatric Population: Focus on Migraine
Samantha L Irwin1, Kaitlin A Greene2, Sara J Pavitt3
1Department of Neurology, University of California, San Francisco (UCSF), California.
Insights
Pediatric headaches are common and impact daily life, but most cases involve primary headache disorders diagnosed through clinical history. Prompt diagnosis and multidisciplinary management lead to favorable outcomes for children with headaches.
Area of Science:
- Neurology
- Pediatrics
- Clinical Medicine
Background:
- Pediatric headache is a prevalent condition affecting children's quality of life and daily functioning.
- Primary headache disorders are the most common cause of headaches in pediatric patients presenting to clinics.
- Accurate diagnosis is crucial for effective management and treatment strategies.
Purpose of the Study:
- To review the diagnosis and management of pediatric headache disorders.
- To emphasize the importance of clinical history in diagnosing primary headaches.
- To highlight the role of a biopsychosocial model in treatment.
Main Methods:
- Diagnosis relies primarily on detailed clinical history.
- Neuroimaging is typically not required unless specific red flag symptoms are present.
- Treatment integrates lifestyle adjustments, pharmacologic, and nonpharmacologic approaches.
Main Results:
- Most pediatric headaches stem from primary disorders, diagnosed clinically.
- Off-label use of therapies is common due to limited pediatric-approved treatments.
- Multidisciplinary care and prompt diagnosis correlate with better outcomes.
Conclusions:
- Effective management of pediatric headaches involves a comprehensive biopsychosocial approach.
- Early diagnosis and integrated care in a multidisciplinary setting improve patient outcomes.
- While many treatments are extrapolated from adult data, outcomes are generally positive with appropriate management.
Abstract:
Pediatric headache is a common condition with significant impact on quality of life and ability to function in academic, social, and extracurricular activities. Most pediatric patients seen in primary care and neurology clinics with headache have primary headache disorders. Diagnosis is largely based on clinical history. Imaging is rarely needed in the absence of red flag features. Careful diagnosis is important to guide appropriate treatment. Treatment focuses on a biopsychosocial model integrating lifestyle, pharmacologic and nonpharmacologic treatment modalities. As few therapies are approved in the pediatric population, treatments are often used off-label based on evidence extrapolated from adult studies. Outcomes vary over time but are generally favorable when headache disorders are diagnosed promptly and managed in a multidisciplinary setting.
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