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Headache diary in the diagnosis of childhood migraine
L Metsähonkala1, M Sillanpää, J Tuominen
1Department of Child Neurology, Turku University, Finland.
Insights
A headache diary significantly aids in diagnosing pediatric migraine and clarifying symptoms. This tool helps identify more cases and understand headache characteristics in children.
Area of Science:
- Pediatric Neurology
- Clinical Research
Background:
- Migraine diagnosis in children can be challenging.
- Understanding specific headache symptoms is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the utility of a headache diary in diagnosing migraine in children.
- To assess the diary's role in clarifying migraine symptoms and headache characteristics.
Main Methods:
- A longitudinal study followed 145 children from a birth cohort.
- Headache status was assessed via interview and a 2-7 month headache diary.
- Diagnosis utilized International Headache Society criteria.
Main Results:
- The headache diary identified 8 additional migraine cases (11.1%) not found in interviews.
- 33 children reported both migraine and non-migrainous headaches in the diary, but only one type in interviews.
- Diary entries revealed underestimated headache duration and new aura/associated symptoms compared to interviews.
Conclusions:
- Headache diaries are valuable tools for diagnosing pediatric migraine.
- Diaries enhance the clarification of headache attack features and types in children.
- Utilizing diaries improves the comprehensive understanding of pediatric headache disorders.
Abstract:
The usefulness of a headache diary in the diagnosis of migraine and in the clarification of migraine symptoms was studied in 145 children. These children belong to a 1-year age cohort of 5356 children that has been followed since birth. The children were enrolled in the present study according to their headache status in a questionnaire study at the age of 8 to 9 years, at which time 50 children had migraine, 43 had nonmigrainous headache, and 52 did not have recurrent headache. Information on their present headache status was collected with a face-to-face interview at the age of 11 to 13 years and from a headache diary after the interview. The children kept the diary for 2 to 7 months. Altogether, 72 children had migraine according to the International Headache Society criteria for migraine, either in the interview or in the diary. Eight children were diagnosed only according to the diary (11.1%). Thirty-three children had both migraine attacks and nonmigrainous headache episodes according to the diary, even though they were able to report only one type of headache episode in the interview. The duration of headache episodes was underestimated in the interview, compared to the diary, in the children with migraine. Many children recognized new aura symptoms, associated symptoms, and characteristics of pain when they started to pay attention to these when filling in the diary during the follow-up period. The headache diary is useful in clarifying the features of headache attacks and in the diagnosis of headache types in children.