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Pediatric headaches: what do the children want?
D W Lewis1, M T Middlebrook, L Mehallick
1Department of Pediatrics, US Naval Hospital, Portsmouth, VA, USA.
Headache
|April 1, 1996
Summary
Pediatric headaches are predominantly migrainous, with children seeking physician reassurance about the cause and severity. Many young patients express significant emotional distress, including feelings of hopelessness and even death, through their drawings.
Area of Science:
- Pediatric Neurology
- Child Psychology
Background:
- Headaches are a common complaint in children presenting to primary care.
- Understanding the specific types and patient-reported reasons for seeking care is crucial for effective management.
Purpose of the Study:
- To characterize headache types and associated features in pediatric patients.
- To explore children's perceptions and emotional responses to headaches.
- To identify key information children seek from physicians regarding their headaches.
Main Methods:
- A survey was administered to 100 consecutive pediatric patients (aged 3-17) with >3-month headache history.
- Patients completed questionnaires on headache characteristics and reasons for physician consultation.
- Nonverbal perceptions were assessed through children's drawings depicting their headache experience.
Main Results:
- Over 90% of headaches were identified as migrainous (common, classic, or basilar).
- Children primarily desired information on headache cause, effective treatments, and reassurance against serious illness.
- Illustrations revealed significant emotional distress, with 33% showing depressive features and over 20% of adolescents depicting themes of death or dying.
Conclusions:
- Migrainous headaches are highly prevalent in pediatric primary care.
- Children's emotional well-being and their need for clear communication and reassurance are critical aspects of headache management.
- Art-based assessments can offer valuable insights into a child's subjective experience of chronic pain.