Characterization of chronic daily headaches in children in a multidisciplinary headache center.
BACKGROUND
Chronic daily headaches (CDH) occur in >4% of the adult population. The criteria for CDH, however, are controversial. In children, the characterization of frequent headaches and CDH is limited.


METHODS
A Headache Center to characterize headaches in children (3 to 18 years old) was established. Over 34 months, 577 children have been evaluated. With use of a definition of > or =15 headaches per month, 200 (34.6%) children had CDH.


RESULTS
The average age at the first headache in these children was 9.3 +/- 3.6 years, whereas the average age at presentation to the Headache Center was 12.5 +/- 3.1 years. Sixty-eight percent were girls, 88% were Caucasian, and 11% were African American. Ninety-two percent clinically had migraine headaches, whereas 60.5% met the International Headache Society migraine criteria. The pain was pulsatile in 79%, 63.5% had nausea with or without vomiting, and 59.5% had photophobia and phonophobia. Three subcategories emerged, with 37% having frequent headaches but not daily, 43.5% having episodic daily headaches, and 19.5% having a continuous headache.


CONCLUSIONS
The features of CDH in children most closely match those of migraine. A clear division of these children using frequency identifies three groups: frequent headaches (15 to 29), daily intermittent, and daily continuous. The daily continuous group is the most unique; however, the nature of these headaches continues to remain migrainous.
Hershey
A D
AD
Division of Neurology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Powers
S W
SW
Bentti
A L
AL
LeCates
S
S
deGrauw
T J
TJ
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D020773:Headache Disorders / Q000145:classification / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020325:Migraine with Aura / Q000145:classification / Q000503:physiopathology; D020326:Migraine without Aura / Q000145:classification / Q000503:physiopathology; D018710:Pain Clinics; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors