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Childhood headache at school entry: a controlled clinical study
M Aromaa1, M L Sillanpää, P Rautava
1Department of Child Neurology, University of Turku, Finland.
Insights
Headache in schoolchildren is linked to bruxism and specific tender points. Identifying triggers like food, fear, and anxiety can help classify headache types in children.
Area of Science:
- Pediatric Neurology
- Clinical Epidemiology
Background:
- Headache is a common complaint in childhood, impacting daily life and school attendance.
- Accurate classification of headache types in children is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence, characteristics, and triggers of various headache types in Finnish children commencing school.
- To identify clinical indicators and associated factors for headache in this age group.
Main Methods:
- A questionnaire survey was distributed to 1,132 families of 6-year-old children.
- Children experiencing headaches (n=96) and a control group (n=96) underwent clinical interviews and examinations.
Main Results:
- Children with headaches showed higher rates of bruxism, tenderness in occipital muscle insertion and temporomandibular joint areas, and travel sickness.
- Migraineurs reported specific triggers (ice cream, fear, anxiety) and concurrent symptoms (abdominal pain) more frequently than those with tension-type headaches.
- Children with migraine also had higher medication use for pain relief.
Conclusions:
- Palpation of occipital muscle insertions and temporomandibular joint areas can aid in headache classification.
- Discerning a history of triggering events and concurrent symptoms is valuable for improving headache diagnosis in children.
Objective:
Our objective was to study the prevalence of different headache types, characterizations, and triggers of headache in Finnish children starting school.
Methods:
Questionnaires were sent to 1,132 families with 6-year-old children. Children with headache disturbing their daily activities (n=96) and an asymptomatic control group of children (n=96) participated in a clinical interview and examination.
Results:
Children with headache had significantly more bruxism (odds ratio [OR], 1.9; 95% CI, 1.0 to 3.4), tenderness in the occipital muscle insertion areas (OR, 4.8; 95% CI, 1.8 to 12.7), and tenderness in the temporomandibular joint areas (OR, 2.8; 95% CI, 1.3 to 6.0). They also had more travel sickness (OR, 3.4; 95% CI, 1.7 to 6.7) than control children. Eating ice cream (OR, 5.3; 95% CI, 1.4 to 20.3), fear (OR, 3.7; 95% CI, 1.2 to 11.2), and anxiety (OR, 3.2; 95% CI, 1.0 to 10.8) triggered headache more often in migraineurs than in children with tension-type headache. Children with migraine also reported more frequently abdominal (OR, 5.6; 95% CI, 1.7 to 18.1) and other (OR, 3.5; 95% CI, 1.2 to 9.8) pain concurrently with headache, and they used medication for pain relief more often (OR, 3.1; 95% CI, 1.0 to 9.5).
Conclusions:
Headache classification in children may be improved by palpation of occipital muscle insertions and temporomandibular joint areas, and by discerning a history of triggering events and concurrent symptoms.