Overview of Headache in Children and Adolescents in an Outpatient Neuropediatric Center from 2014 to 2015

Abstract

Introduction: Headache in children is one of major causes for consultation in neuropediatric outpatient clinic. The estimated mean prevalence of headache in children and adolescents is ~54%. This study aims to evaluate the outpatient workup in the neuropediatric clinic of Innsbruck in a 2-year period. Results: We collected data from 93 patients with headache during a 24-month timeframe; 78% of them were females. Around 50% were older than 15 years, and 16% were younger than 10 years of age. The majority of patients were diagnosed as migraine headache. Thus, many children showed both migraine and tension-type headache, or a switch from one type to the other. The biggest part of patients had a higher education (36%). More than 60% had a positive family history for headache. We found a coincidence of obesity and headache in 20%. EEG was performed in 78% and cerebral MRI was done in 60%. Incidental findings were found in 18 patients (19%): none of them had therapeutic consequence. We found no malignancy. One patient presenting with headache was later diagnosed as POLG mutation. We had at least one follow-up visit in 80% of patients. One-fifth of the patients did not perceive the last schedule. Conclusion: The type of headache may switch within months in children and adolescents; classification is often difficult. The extent of diagnostic workup varies and depends on presentation and history. Incidental findings in cerebral MRI are common, mainly without therapeutic consequence. As limitation, this group is collected from scheduled outpatients; therefore, no urgent cases are presented.