Outcome of Chronic Daily Headache in Adolescents

Abstract

Neurology| June 01 2007 Outcome of Chronic Daily Headache in Adolescents AAP Grand Rounds (2007) 17 (6): 68. https://doi.org/10.1542/gr.17-6-68 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Outcome of Chronic Daily Headache in Adolescents. AAP Grand Rounds June 2007; 17 (6): 68. https://doi.org/10.1542/gr.17-6-68 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: chronic daily headache, headache Source: Wang S-J, Fuh J-L, Lu S-R, et al. Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study. Neurology. 2007;68:591–596; doi:10.1212/01. wnl.0000252800.82704.62 Outcomes and predictors of chronic daily headache (CDH) were determined in a two-year longitudinal study of a sample of 122 adolescents (32 male/90 female; ages 12–14) based on annual telephone follow-up by neurologists at Taipei Veterans General Hospital, Taiwan. CDH was defined as ≥15 headache days/month, average of two hours/day or more, for more than three months. All study patients met criteria for CDH at enrollment in 2000. Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency for study patients was 11.0 ± 9.7 days during the first year of follow-up and 7.7 ± 6.5 days in the subsequent year. At the one-year follow-up, symptoms in 40% of study patients met criteria for CDH; by the year two follow-up the persistence rate was 25%. A gender difference was observed: only 4% of boys vs 32% of girls had persistent CDH at two-year follow-up. At baseline, 20% of patients met criteria for medication overuse; this decreased to 6% at two years. Based on the International Classification of Headache Disorders (ICHD-2)1 the prevalence of chronic migraine was not significantly changed during follow-up (67% at baseline and 60% at two years), whereas chronic tension-type headache (CTTH) decreased from 86% to 46% in the same time interval (P<.001). However, because the ICHD-2 criteria for diagnosing chronic migraine were felt to be too restrictive, they were revised in 2006.2 Based on the revised criteria, migraine prevalence increased three to four times when compared with the original ICDH-2 criteria, and chronic migraine became more common than CTTH in patients with persistent CDH in 2001 and 2002. Headaches were found to adversely affect learning at school in 56% of patients at the one-year follow-up and in 57% at the second follow-up; seven (6%) dropped out of school during the two-year study period. Poor outcome predictors included female gender, chronic migraine, medication overuse, major depression, anxiety disorders, school phobia, and obsessive compulsive disorder. Independent predictors for CDH persistence were medication overuse (P<.05) and major depression (P<.01). In contrast, migraine, age at CDH onset, and CDH duration were not significant predictors of the persistence of CDH. Dr. Millichap has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of a commercial product/device. This commentary does not contain a discussion of an unapproved/ investigative use of a commercial product/device. This report is an extension of a Taiwan study of the prevalence of headache and medication overuse in adolescents with chronic daily headache (CDH).3 The prevalence was 2.4% in girls and 0.8% in boys. CDH was subtyped as CTTH in 65.6% and chronic migraine in 6.6%; medication overuse CDH occurred in 20% of cases. Whereas the incidence of CDH in adolescents declined over a two-year follow-up, the relative prevalence... You do not currently have access to this content.