Headaches in childhood.
Childhood headache is a common problem. The approach to evaluation and therapy is similar to that in adults with the exception that the differential is slightly altered and varies by age. Methods of evaluation have been proposed based on the time course of the illness as well as on pathophysiologic considerations. Although serious intracranial disease needs to be ruled out, in most cases chronic recurrent headache of childhood represents migraine. When doubt exists, close follow-up for 4 to 6 months should clarify the issue. Migraine variants are described that are uncommon or not seen in adults, and their differential diagnosis is discussed. The most difficult differential is between that of migraine and seizures. Variations in history and associated findings are described to help in the diagnosis of seizure versus migraine. Finally, methods of treatment are given based on my experience and review of the current literature. Many patients with migraine will improve over time regardless of what is done, and this should be kept in mind when treating these patients.
Hanson
R R
RR
Department of Pediatrics, University of Mississippi Medical Center, Jackson 39216.
D002648:Child; D002675:Child, Preschool; D006261:Headache / Q000145:classification* / Q000209:etiology / Q000628:therapy; D006801:Humans