Chronic Daily Headache In Adolescents Research Articles

Transnasal Sphenopalatine Ganglion Block for the Preventive Treatment of Chronic Daily Headache in Adolescents.

Chronic headaches are a major source of morbidity in the pediatric population, affecting physical function, school attendance, social capacity, mood, and sleep. In adults, repetitive sphenopalatine ganglion (SPG) blockade has been studied as a preventive treatment for chronic migraines. This case series aims to evaluate the SPG block for the preventive treatment of chronic daily headache (CDH) in adolescents. We prospectively evaluated 17 adolescents (14 females, 14 ± 1 year) with CDH not responding to cognitive behavioral therapy (CBT), physiotherapy, and standard medications. Each patient received 10 SPG blocks (two blocks/week) using the Tx360® device. At the end of treatment, 10 patients (59%) reported a Patient’s Global Impression of Change (PGIC) score ≥ 67%, and 3 months after the end of treatment, nine patients (53%) sustained a PGIC ≥ 67%. There was also a statistically significant reduction in the depression subscale of the Revised Children’s Anxiety and Depression Scale (RCADS) at the end of treatment and 3 months post-treatment compared with baseline. The procedure was well tolerated with no adverse effects. In our study, the use of repeat SPG blockade was associated with sustained benefits on the PGIC and the depression subscale of the RCADS when used as preventive headache treatment in adolescents with refractory CDH.

Common Presentations of Chronic Daily Headache in Adolescents

Common Presentations of Chronic Daily Headache in Adolescents

Botox Treatment for Migraine and Chronic Daily Headache in Adolescents

Children and adolescents experience headaches as do adults and usually present with migraine and chronic daily or tension-type headaches. As some adolescents are unable to achieve headache relief after various treatment strategies, we currently provide botulinum toxin type A (Botox) injections as a clinical treatment (off-label use) in selected cases. Botulinum toxin type A by injection has been found to be effective in the treatment of headache disorders in adults. We treated 12 adolescents (aged 14 to 18 years) with Botox injections for migraine and chronic daily headache. Six patients (all female adolescents) were in long-term treatment and received Botox in the standard "migraine" and "follow-the-pain" patterns every 3 months. Effectiveness was evaluated using pain scales and a standardized quality-of-life survey at baseline and prior to each treatment session. Duration of treatment was 3-29 months. Each patient had 9-63 (average = 42) injections per treatment. All 6 long-term patients reported improvement in headache symptoms, with decreases on pain scales and an average of 33%-75% improvement in quality of life. Two long-term patients had complete relief of headaches between injection series. Four patients had only one series of injections with good results. Two patients had no improvement and refused additional injections. Side effects were mild ptosis (n = 1), blurred vision (n = 1), hematoma at neck injection site with tingling in one arm lasting 24 hours (n = 1), and burning sensations at all injection sites which lasted 1 week (n = 1). Our group findings warrant a controlled trial evaluation of Botox because it may be an effective treatment option for certain adolescents with intractable migraine and chronic daily headaches.

Outcome of Chronic Daily Headache in Adolescents

A community-based sample of 122 adolescents aged 12-14 years with chronic daily headache (CDH) was established in 2000 at University centers in Taiwan by a survey of 7,900 students in 5 selected public middle schools.

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### Chronic daily headache in adolescents: An 8-year follow-up study This long-term study investigates the outcomes of adolescents with chronic daily headache (CDH) when they grow to young adulthood. The frequency of CDH markedly declines to 12%, but one fourth of them still suffer significant headache disability. Poor outcome predictors include medication overuse, migraine history, and early onset of CDH. See p. 416; Editorial, p. 412 ### Decreased GABA-A binding on FMZ-PET in succinic semialdehyde dehydrogenase deficiency This study presents groundbreaking research in succinic semialdehyde …

Chronic daily headache in adolescents

To assess the long-term outcome of a community-based adolescent cohort with chronic daily headache (CDH). A field sample of 122 adolescents aged 12-14 years with CDH was established in 2000 (baseline) with short-term follow-up studies in 2001 and 2002. In 2008, the cohort was re-interviewed by physicians via telephone to determine the headache profile for the past year, including Migraine Disability Assessment (MIDAS), a headache disability questionnaire. Presence of CDH was defined as >or=15 headache days/month, average >or=4 hours/day for >3 months. Outcome measures included headache frequency, MIDAS score, and presence of CDH in 2008. A total of 103 subjects (26 male/77 female, mean age 21.6 +/- 0.9 years) completed the study (response rate 84.4%). The average monthly headache frequency was 4.7 +/- 6.0 (0-30) days. Twenty-eight (27.2%) subjects had moderate or severe headache disability (MIDAS >or=11). Twelve (12%) subjects met CDH criteria, with chronic migraine (n = 10, 83%) as the most common subtype. Two (2%) subjects overused medications. From 2000 to 2008, the frequencies of migraine diagnoses were fairly consistent in this cohort. Presence of migraine at baseline predicted poorer outcome of all 3 measures. Additionally, CDH onset <13 years old, duration >or=2 years, and medication overuse predicted either higher headache frequencies or presence of CDH in 2008. This long-term follow-up study revealed a marked decline in the frequency of chronic daily headache (CDH). However, one fourth of patients still had significant headache disability. Migraine history was a major factor in evolution of CDH into young adulthood. Early onset and longer duration of CDH implied a protracted disease course.

Outcome of Chronic Daily Headache in Adolescents

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.

Outcomes of Chronic Daily Headache in Adolescents

The outcomes and predictors of chronic daily headache (CDH) were determined in a 2-year longitudinal study of a sample of 122 adolescents (32 male/90 female; ages 12-14) with annual telephone follow-up by neurologists at Taipei Veterans General Hospital, Taiwan.

Persistence of Chronic Daily Headache in Adolescents

In this community-based, longitudinal study, researchers assessed outcomes and predictors of chronic daily headache (CDH) in 122 Taiwanese middle-school students (32 boys and 90 girls, of almost 8000 students initially surveyed). The 122 children with CDH completed 1-year and 2-year follow-up surveys. CDH was defined as 15 or more headache days per month, for at least 2 hours per day, for more than 3 …

Outcomes and predictors of chronic daily headache in adolescents

To assess the outcomes and predictors of chronic daily headache (CDH) in a community-based cohort of adolescents. We established a field sample of 122 adolescents (32 M/90 F, ages 12 to 14) with CDH in 2000. These adolescents received annual follow-up by neurologists for 2 years via a semistructured telephone interview. CDH was defined as > or =15 headache days/month, average > or =2 h/day for >3 months; subtypes were classified based on the original and appendix criteria of the International Classification of Headache Disorders (2nd ed.; ICHD-2). Poor outcome was defined as persistence of CDH at 2 years. Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency was 11.0 +/- 9.7 days in 2001 and 7.7 +/- 6.5 days in 2002. CDH persistence rates were 40% in 2001 and 25% in 2002. Medication overuse declined from 20% (baseline) to 6% at 2 years. The prevalence of migraine did not change throughout the follow-up (67 to 60%), whereas that of tension-type headache deceased from 86 to 46% (p < 0.001). Chronic migraine prevalence increased markedly at baseline and became the most common CDH subtype at follow-up when using the ICHD-2 appendix criteria. During follow-up, seven subjects (6%) dropped out of school. Independent predictors for CDH persistence were medication overuse and major depression. Most adolescents with chronic daily headache (CDH) continued to have frequent headaches, although the incidence of CDH declined at follow-up. Migraine diagnosis gained prominence as headache frequency decreased. The percentages of chronic migraine in adolescents with CDH increased obviously if the appendix criteria were applied.

Chronic daily headache in adolescents

To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample. The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition. Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents. Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

The Classification of Chronic Daily Headache in Adolescents—A Comparison Between the Second Edition of the International Classification of Headache Disorders and Alternative Diagnostic Criteria

To compare the second edition of the International Classification of Headache Disorders (ICHD-2) and the Silberstein-Lipton (S-L) criteria in the classification of adolescents with chronic daily headache (CDH). We reviewed the clinical records and the headache diaries of 170 adolescents (13 to 17 years) seen between 1998 and 2003 at a headache center. Relevant information was transferred to a standardized form that included operational criteria for the ICHD-2. CDH subtypes were classified according the criteria proposed by S-L into transformed migraine (TM) with (TM+) and without medication overuse (TM-), chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). From the 69 patients with TM- according the S-L criteria, most (71%) could be classified as chronic migraine (CM), while a minority of patients required a combination of diagnosis, mainly migraine and CTTH (14.4%). Of the patients with TM+, just 39.6% met the criteria for probable CM (PCM) with probable medication overuse (PMO). If instead of 15 migraine days per month, we considered 15 or more days of migraine or probable migraine, 84% of the subjects with TM- and 68.7% of those with TM+ could be classified. Of the 27 subjects classified as NDPH without medication overuse according to the S-L system, the majority (51.2%) were also classified as NDPH according the ICHD-2. Interestingly, three (11.1% of the subjects with NDPH without medication overuse) were classified as CM in the ICHD-2 because these patients had an abrupt onset of 15 or more days of migraine per month. All patients with NDPH with medication overuse according to the S-L criteria required a combination of diagnoses in the ICHD-2. All subjects with CTTH received a single diagnosis in both classification systems. (i) Among adolescents with TM, the majority (58.1%) could be classified as CM, according to the ICHD-2. These results were driven by TM without medication overuse. (ii) If the ICHD-2 criteria for CM are revised to require 15 days of migraine or probable migraine, the proportion of patients with TM- who meet the criteria for CM increases from 71% to 84%; for TM+, the proportion with probable chronic migraine and PMO increases from 30% to 68%. (iii) About half of the patients with NDPH according to the S-L criteria have too many migraine features to meet ICHD-2 criteria for NDPH.