Chronic daily headache in adolescents: Prevalence, impact, and medication overuse

Wang S-J, et al. Neurology. January 2006; Vol. 66, Iss. 2, pp. 193-197

Objectives: To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample.

Methods: The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition.

Results: Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents.

Conclusions: Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

Children Relate Headaches to Emotional Stress.

Working on the assumption that children probably have insights into what triggers their own headaches, Dr. Birgitta Hovelius and colleagues took the novel approach of actually asking a group of 10 to 14-year-olds about their experience of headache.

"We are trying to understand children's intuitive knowledge and understanding of factors affecting their health from the point of view that their narratives represent an important source of knowledge in the area of medical research," Dr. Hovelius told Reuters Health. "Such research has been neglected."

The children consistently linked their headaches with conditions in school, the researchers report in The British Journal of General Practice. "Specifically with more theoretically oriented subjects--mathematics or Swedish -- a noisy and disorderly school environment, and insecure relations with classmates."

Another regular theme when the children were encouraged to talk freely was insecurity or conflict in their family. Read the entire article at medscape.com.

TV Watching Leads to Health Problems in Children

In addition to obesity, children who watched Tv for longer hours had an increased risk of headache, back pain, eye symptoms and sleep problems were found to be more often among children who watched television longer

Toyran M, Ozmert E, Yurdakok K   Television viewing and its effect on physical health of schoolage children   Turk J Pediatr 2002 (Jul);   44 (3):   194-203

Headaches Common in Young Children

Migraine headaches are common in children, and incidence increases through adolescence, affecting about 8% to 23% of children aged 11 to 15 years. Average age of onset is 7.2 years for boys and 10.9 years for girls.

Neurology. 2004;63(12):2215-2224

Coenzyme Q10 May Ward Off Migraine Attacks

"Coenzyme Q10 proved to have a significant effect in reducing migraine propensity and had an extremely favorable side-effect profile," lead author Peter S. Sandor, MD, research fellow in the neurology department at University Hospitals in Zurich, Switzerland, said during a presentation.


Drug Rebound Headache Common in Youths

Many parents don't think twice about giving their youngsters over-the-counter pain medications. However, new research supports what doctors of chiropractic have long suspected: pain medication often does more harm then good.

The study looked at 26 adolescents in Israel with chronic headache. Those who reported headaches 25 days out of each month also reported taking aspirin, acetaminophen or codeine on a daily or near-daily basis (average of 28 pills each week). When these youths discontinued taking medication, their headache frequency dropped to fewer than 3 days per month.

Hering-Hanit R, Cohen A, Horev Z.  Successful withdrawal from analgesic abuse in a group of youngsters with chronic daily headache   J Child Neurol 2001 (Jun);   16 (6):   448-449

Childhood Headache my lead to Adult Conditions Children with frequent headaches are at an elevated risk of headaches and other conditions during adulthood, say scientists in the British Medical Journal.  Investigators tracked 17,414 subjects from age 7 to age 33. In total, 8.2% of participants suffered from headaches at age 7. This figure jumped to 14% at age 33. Children with headaches were at more than double the odds of suffering from headaches as adults. They were also significantly more likely to develop other physical and psychiatric symptoms, compared with headache-free youngsters

These findings confirm that children with headaches do not simply "grow out" of their physical complaint, but may instead "grow into" others, say the authors.

Fearon P, Hotopf M.  Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study   Brit Med Jou 2001 (May 12);   322 (7295):   1145

Migraines on the Rise Incidence of medically recognized migraine skyrocketed over the last several years, say scientists in the journal Neurology. The study found that clinically diagnosed migraine leaped 56% between 1979 and 1990. This increase was primarily due to a jump in migraine occurrence among females aged 10 to 49 years, say researchers.

Rozen, TD, Swanson, JW, Stang, PE, McDonnell, SK, Rocca, WA   Increasing incidence of medically recognized migraine headache in a United States population   Neurology 1999 (Oct 22);   53 (7):   1468-1473

Starting School Raises Headache Occurrence Starting school can be emotionally traumatic for a child. Now an article Pediatrics suggests that starting school may also have physical ramifications. Specifically, starting school increases a student's likelihood of headache.

The study followed 1,290 6- and 7- year-old children for two years.  According to the report, "A significant increase in the incidence density of overall headache in children was found during the first 12 school months, compared with the 6 months immediately before school started or with the subsequent 6 school months (13th-18th month). The increase was attributable to occasional headache. During the first school months, the frequency of headache increased in 20% of children who had had headache before the 6 months preceding the start of school."

Anttila P, Metsahonkala L, Sillanpaa M   School start and occurrence of headache   Pediatrics 1999 (Jun);   103 (6):   e80

Additional Articles on Children's Headaches:

Pediatric Headaches by Claudia Anrig, DC
Dynamic Chiropractic Archives - August 10, 1998

Diagnosing Childhood Headaches by Peter Fysh, DC
Dynamic Chiropractic Archives - February 12, 1993

Children Get Headaches, Too by Peter Fysh, DC
Dynamic Chiropractic Archives - January 15, 1993

The Chiropractic And Headache Page @ Chiro.Org

Chiropractic Spinal Manipulation for Cervicogenic Headache in an 8-Year-Old
The Chiropractic Resource Organization