Abstract
The aim of our study was to evaluate the long-term outcomes of pediatric migraine and TTH in a clinical setting. We conducted a cohort study. Pediatric patients who visited the pediatric neurology clinic due to diagnoses of migraine or TTH were contacted by phone 8–10 years after their initial diagnosis and interviewed about their outcomes. Of 147 children, we were able to reach 120 (81%) patients. Of these 120 patients, 59 were seen initially due to migraine and 61 due to TTH. For the migraine patients, headaches improved in 48 (81.4%) and worsened in four (6.8%). Regarding diagnosis at follow-up, 59% still had migraine, 17% had TTH, and 23% were headache-free. Aura and photophobia were significantly associated with persistence of a migraine diagnosis. For the TTH patients, headaches improved in 49 (81.7%) and worsened in nine (15.0%). Regarding diagnosis at follow-up, 36.7% still had TTH, 18.3% had migraine, and 45% were headache-free. Of the patients with TTH, 36.7% retained their initial diagnosis compared to 59.3% among the migraine patients. Most pediatric patients presenting with migraine or TTH will experience a favorable outcome over 10 years, with TTH patients having twice the chance of complete resolution.
Highlights
Headaches are very common in children and adolescents
The prevalence of migraine during the preschool years is as low as 3%, it increases by the early school years to 11%, and during the high school years, it is as high as 23% [3]
Mean time elapsed since the initial diagnosis was 9.3 years
Summary
Headaches are very common in children and adolescents. Migraine and tension-type headache (TTH) are the most common headache syndromes in children [2]. Boys have more episodes of migraine than girls, but after puberty migraine headaches occur more frequently in girls, as is seen among adults [2]. The mean age of onset for migraine is 7 years for boys and 11 years for girls [1]. A third of children and adolescents who have migraines report experiencing aura before onset of the headache [4,5,6]. The prevalence of TTH is not much different from migraine, varying from 9 to 18% [5] and increasing with age
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