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Published on: June 2, 2014
Chronic daily headache in children and adolescents: a 2-year prospective study
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore, USA.
Insights
Chronic daily headache in children and adolescents presents with distinct patterns, but overall disability remains similar across diagnoses. This study highlights key differences compared to adult chronic daily headache.
Area of Science:
- Pediatric Neurology
- Headache Medicine
- Clinical Pediatrics
Background:
- Chronic daily headache (CDH) in pediatric populations is not well-characterized.
- Understanding CDH patterns in children and adolescents is crucial for effective management.
Purpose of the Study:
- To describe the clinical patterns and associated disability of chronic daily headache in children and adolescents.
- To identify distinct headache classifications within this pediatric cohort.
Main Methods:
- Retrospective analysis of 37 pediatric patients with chronic daily headache over two years.
- Classification of headache patterns into predefined categories.
- Assessment of behaviors, disability, pain severity, school absenteeism, and coping skills.
Main Results:
- Five distinct headache patterns were identified: comorbid (40%), new daily persistent headache (35%), transformed migraine (15%), chronic tension-type headache (5%), and unclassified (5%).
- No significant differences were observed in behavioral measures, disability, pain severity, school days missed, or coping skills across the diagnosed groups.
- Children and adolescents with CDH exhibit varied clinical presentations but largely similar levels of functional impairment.
Conclusions:
- Chronic daily headache in children and adolescents manifests in several distinct clinical patterns.
- Despite varied headache types, the overall disability associated with chronic daily headache in this age group is comparable.
- Key differences exist between adult and childhood chronic daily headache presentations and impact.
Abstract:
Chronic daily headache in children and adolescents has not been well described. We analyzed data for 37 children and adolescents who presented with chronic daily headache to our Pediatric Headache Clinic over a 2-year period. These youngsters had five distinct headache patterns; 40% of them had the "comorbid" pattern, 35% were classified with new daily persistent headache, 15% with transformed migraine, 5% with chronic tension-type headache, and 5% could not be classified. There were no significant differences by diagnosis in externalizing and internalizing behaviors, type A behaviors, disability, pain severity, days missed from school, and number of coping skills employed. Children and adolescents with chronic daily headache have distinct clinical patterns, but for the most part, have similar disability. Differences between adult and childhood chronic daily headache are emphasized.
