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Chronic Daily Headache in Children and Adolescents

Published online by Cambridge University Press:  02 December 2014

Shashi S. Seshia
Shashi S. Seshia*
Affiliation:
Manitoba Clinic, Winnipeg, MB, Canada
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Abstract

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Objective:

Characterize chronic daily headache in those less than 20 years of age. Material and

Methods:

Study design: Prospective, observational, and sequential.

Setting:

Private practice Pediatric Neurology Clinic in a Canadian city (Winnipeg).

Patients and data collection:

Data on those referred with headache between September 1998 and December 2001 were entered on data sheets. Patients were followed up for one month to four years.

Results:

One hundred and forty-three (31%) of 463 referred with headache had chronic daily headache with duration of one month to five years (median: eight months). The age range was 5.5 years to 20 years (median: 13 years). There were significantly more females (N=93) than males (N=50). The main groups were: (1) transformed migraine: 6 (4%), (2) transformed tension-type headache: 80 (56%) and (3) transformed comorbid migraine and tension-type headache: 39 (27%). Tension-type features dominated in 94%. Analgesia overuse occurred in two. Stressors were recognized in 60 (42%); anxiety disorder was diagnosed in 8 (6%), and depression in 13 (9%). Computed tomography scans were done in 31 (22%), and MRI/MR angiography in 8 (6%) and were normal or showed nonspecific incidental findings. Twenty-two (15%) were lost to follow-up; 115 of the remaining 121 (95%) were headache free or greatly improved, 63 (55%) without specific treatment.

Conclusion:

Chronic daily headache is a common headache disorder in children and adolescents, especially in teenage girls. A prospective neuropsychiatric approach is necessary for evidenced-based management, since the condition has mental health, social and economic ramifications.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 3 , August 2004 , pp. 319 - 323
Copyright
Copyright © The Canadian Journal of Neurological 2004

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