title: Characterization of chronic daily headaches in children in a multidisciplinary headache center.
abstract: 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.
authors.affiliation: Division of Neurology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Hershey
authors.forename: S W
authors.initials: SW
authors.lastname: Powers
authors.forename: A L
authors.initials: AL
authors.lastname: Bentti
authors.forename: S
authors.initials: S
authors.lastname: LeCates
authors.forename: T J
authors.initials: TJ
authors.lastname: deGrauw
mesh_terms: 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