Chronic daily headache in children and adolescents.
OBJECTIVE
To describe the clinical features of children with chronic daily headache (CDH) and examine the usefulness of the International Classification of Headache Disorders-II.


BACKGROUND
Few data are available on chronic daily headache and analgesic overuse in children and adolescents and there are no specific criteria for headache in children.


METHODS
We retrospectively reviewed all charts of 79 children and adolescents (<16 years) with headache on > or =15 days/month presenting to the outpatient clinic of the Department of Neurology of the Leiden University Medical Center between 1994 and 2001. We classified their headaches according to the International Classification of Headache Disorders-II.


RESULTS
Fifty-seven (72%) children had chronic daily headache for more than 6 months, with a duration of more than 4 hours a day in 60% of them. Quality, severity, and location of pain varied. Sixty patients (76%) used analgesics, 10 patients more than one type. Thirteen patients (16%) used analgesics daily. In one-third of patients, headache led to frequent school absenteeism and sleeping problems. Twenty-eight (35%) patients could be classified, 17 patients (22%) as chronic tension-type headache, 5 patients (6%) as chronic migraine, and 6 patients (8%) as probable medication overuse headache. Fifteen patients (19%) did not fit into any category and 36 (46%) could not be classified due to insufficient data.


CONCLUSIONS
Chronic daily headache in children is a serious disorder. A relatively large number of patients overuse medication and it leads to frequent school absenteeism and sleeping problems. It remains difficult to classify their headaches with the new criteria for headache disorders.
Wiendels
Natalie J
NJ
Dept. of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
van der Geest
Martine C M
MC
Neven
Arie Knuistingh
AK
Ferrari
Michel D
MD
Laan
Laura A E M
LA
D000293:Adolescent; D000700:Analgesics / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy; D006801:Humans; D008297:Male; D012189:Retrospective Studies
D000700:Analgesics