Prevalence Of Headache In Children Research Articles

Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis.

There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63-2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06-1.56), guanfacine (OR = 1.43, 95% CI = 1.12-1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09-1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.

Prevalence of Headache in Children with Epilepsy

Background: Epilepsy is a common pediatric health problem that urges parents to seek medical advice. However, it could be associated with prodromal manifestation [e.g., headache] that the parents usually pass unnoticed. Previous literature is defective regarding the prevalence of headaches among children with epilepsy. Aim of the work: Estimating the prevalence and characteristics of headaches associated with epilepsy in pediatric populations. Patients and methods: We included 130 children with epilepsy [study group] and 130 healthy children as a control group. All were selected from Al-Azhar University Hospitals [new Damietta]. An inquiry about headache and its characteristics, especially in relation to seizure attacks, had been performed. Results: Children with epilepsy had a higher rate of headache when compared to healthy children [48.5% versus 22.3%];migraine is the commonest type in the epileptic group and tension-type headache in the control group. In children with epilepsy, headaches were associated with a higher rate of generalized epileptiform activity, increased frequency of seizures, and monotherapy use. Conclusion: Headache is highly prevalent among children with epilepsy and necessitates proper screening, further investigations, and proper treatment. Future studies to investigate the problem on a wide scale are warranted.

Primary headaches in children and adolescents \u2013 experiences at a single headache center in Korea

BackgroundHeadache is a common complaint in children and adolescents. Recently, an increased prevalence of headache in children and adolescents has been reported.MethodsWe retrospectively reviewed the medical records of children and adolescents attending the Headache Clinic of Daejeon St. Mary’s Hospital during the period from January 2005 through December 2016.ResultsThe study population consisted of 2466 children, aged between 3 and 18 years (mean age: 10.9). Our study showed an increase in the number of patients visiting the hospital with headaches during the past decade. Compared with 2005, the number of patients with headache increased three-fold in 2016. Interestingly, the proportion of boys, preschool children, and other primary headaches revealed a steady and statistically significant increase.ConclusionDue to a steady increase in pediatric headaches, the earlier the problem is recognized and properly diagnosed and a treatment plan is established, the greater the likelihood of a better lifelong outcome. Studies are needed to estimate recent trend in prevalence and to identify the demographic and socioeconomic factors predicting the occurrence of headache.

Prevalence of headaches in children in schools: the case of primary schools in Libreville

Objective: To study the prevalence of headaches in schools.
 Patients and methods: This was a cross-sectional descriptive and analytical study conducted in the ten schools of Libreville, from November 2013 to May 2014. We proceeded by exhaustive recruitment of all the students of the framework, fulfilling the inclusion criteria. We interviewed 5837 school children from 4 to 19 years interviewed and examined children from these schools about
 Results: The sample consisted of 2076 girls (51.0%) and 2861 boys (49.0%); the sex ratio was 0.96 for girls. Grade 5 students were the most represented. The prevalence of headache was 23.5%; 758 (25.6%) girls were prone to headache compared to 615 (21.5%) boys. The prevalence of headache increased with age, 10.6% at 5 years; 22.5% to 6-10 years; 25.9% to 11-15 years and 30.5% to over 15 years. The cephalalgic students were significantly older, ie 10 ± 2.4 years compared to 9 ± 2.5 years for the healthy students. Absenteeism was the most observed pass-through (68.7%), followed by lack of concentration (34.9%) and repetition (3.1%). Isolated headache accounted for 20.0%, compared to 80.0% of symptomatic headaches with the most commonly found oral lesions. Self-medication was the most common means of management (72.0%), with paracetamol as the molecule of choice (65.4%). Conclusion: Headache is a current symptom that is common and disabling. It constitutes a public health problem and must be investigated and adequately addressed to reduce their negative impact on the student's schooling and social life.

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

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.

Headache in school children: is the prevalence increasing?

The objectives of this systematic review were to examine age dependency of headache prevalence in school age children and to assess secular trends of headache prevalence in the last decade, gender and regional differences. A literature search was performed in MEDLINE to identify all prevalence studies in children and adolescents. Five hundred seventy studies were found, of which 37 studies could be included for this review. Headache prevalence in school children increases with their age as demonstrated in cohorts of identical children and cross-sectional surveys covering different age groups of children in one population. Regarding a potential general increase in the prevalence of headache in children and adolescents in the last decade, there are four studies which all show some increase of headache prevalence; however, the degree of increase is varying. Prevalence of headache in girls appears to be higher than in boys. There were no clear regional differences in the prevalence of headache.

Nutraceuticals for the prevention of migraine in children: Do we know what the benefits and the risks are?

Children with headache have limited evidence-based preventive options. When pharmacological measures are considered, it is not surprising that children are using agents considered to be complementary and alternative in dealing with their headaches. Unfortunately, the use of many of these (and other) headache preventives has outpaced the research which may show clear evidence for their use, or, equally possibly, for their inefficacy. Recognition of the current situation should serve both as a call for more research using welldesigned, double-blind, randomized control trials in pediatric headache prophylaxis, as well as for caution until such evidence accumulates. In their review paper in this edition of Cephalalgia, ‘Nutraceuticals in the prophylaxis of pediatric migraine’, (1) Orr and Venkateswaran summarize and critically appraise observational studies and randomized controlled trials in children and adults of six different treatments for migraine prophylaxis: butterbur, riboflavin, ginkgolide B, magnesium, coenzyme Q10 and polyunsaturated fatty acids. Their review is timely and important, given the prevalence of headache in children, widespread interest in nutraceuticals, and their frequent use for a variety of pediatric and adult medical conditions. Nutraceutical use by patients is likely to be driven by several factors: incomplete efficacy of (prescription) drugs, a reluctance to use (prescription) drugs, perceived safety versus prescription drugs, perceived additional health benefits, availability and, perhaps, advertising. Disadvantages of nutraceutical use include expense if not covered by drug plans, fewer randomized control trials of these agents and so less evidence of efficacy, and increased headache burden when effective therapies are overlooked. Additionally, when individual nutraceuticals are untested or used in an unregulated setting, there is potential increased risk of harm. On the other hand, the use of nutraceuticals in the absence of good studies may cause them to be marginalized by physicians seeking such evidence before recommending them, when, if properly supported and launched, good trials might otherwise have shown those nutraceuticals to be effective. Data from the past decade from the US National Health and Nutrition Examination Survey reveal that 34% of children and adolescents routinely use vitamin and mineral supplements (2), despite the American Academy of Pediatrics not recommending supplemental vitamin use in healthy children older than 1 year who consume a varied diet. Multivitamin preparations for older children and adolescents are not regulated by the Food and Drug Administration, leading to concerns about safety and potential adverse effects. A recent analysis of linked data from the 2007 National Health Interview Survey and the 2008 Medical Expenditures Panel Survey evaluated the prevalence of complementary and alternative medicine (CAM) use among all youth in the USA, as well as youth with recurrent headaches (3). As stated by Orr and Venkateswaran, nutraceuticals are a form of CAM, making this analysis relevant. Of all youth between the ages of 10 and 17, 18.7% used at least one CAM modality (and 10.3% of all youth used specific vitamins/minerals). The estimate of youth experiencing headache was 10.6%; of these, 29.6% had used one or more types of CAM in the previous 12 months, compared with 17.4% of youth with the same diagnoses but without headache. Compared with youth with headache who did not use CAM, CAM users were more likely to be older, white, to live in homes with higher incomes, to have private health insurance and higher maternal education (3).

Editorial: Pain management and the undergraduate curriculum – is it a case of ‘could do better’?

There is an old adage that says a society should be judged by how it treats the most vulnerable. It is interesting to apply this concept to the area of pain management. There is perhaps nothing as distressing as a child in pain; the helpless suffering of children touches us at a deeply human level and, I would argue, represents a profound failure of the healthcare system to address the needs of a very vulnerable group. A recent publication by King et al 1 suggests that chronic persistent or recurrent pain in children is ‘overwhelmingly prevalent’ and represents a major health concern for this population. In their review of epidemiological studies, King et al 1 found that the prevalence of headache in children ranged from 8-83%, abdominal pains from 4-53%; and for conditions that physiotherapists are perhaps more associated with , the prevalence rates were: back pain 14 – 24%, musculoskeletal pain 4 – 40%, multiple pains 4 – 49%, and general pain 5 – 88%. Because of the wide variation in reported prevalence rates it is difficult to make generalisations, however, chronic pain in children increased with age, tended to affect girls more than boys, and was associated with psychosocial variables including anxiety, depression and low self-esteem. Most worryingly, these authors suggested that the prevalence of chronic pain in children had increased in the last number of decades. When pain in children becomes chronic or persistent, it can signal long term future health problems. 2 Children with pain often become adults with pain; it is well recognised that pain during infancy causes longlasting changes in pain processing that extend well into childhood and adulthood . 3 Another recent study exploring pain in an extremely vulnerable group, by Maria Walsh and colleagues at the National University of Ireland 4 reported the prevalence and impact of chronic pain in adults with intellectual disability in Ireland (n = 753). These authors found that the overall prevalence of chronic pain in those with intellectual disability was 15.4%, and again the prevalence among females (20.1%) was higher than males (13.4%); Walsh et al 4 cautioned that these figures may even represent an under estimation of the problem. Among the most frequent causes of pain in this population was arthritis and musculoskeletal pain, and with respect to management, massage (29.8%) and physiotherapy (21%), featured among the most common treatments. For those with intellectual disability to have to carry the burden of chronic pain (and almost one third of cases had moderate to severe pain) in addition to the other challenges that their condition brings, is an appalling situation.

Diätetische Kopfschmerzbehandlung bei Kindern

During the past 30 years, the prevalence of headache in children in the western world has significantly increased. Although food intolerance is a well known factor influencing headache in children, the dimensions of this have not been clearly evaluated yet. Severe migraine in children can be mitigated by strict dietary treatment in about 90 % of the cases. But in the long-term, such strict dietary regimes – especially according to Chinese medicine – are hardly practicable. Thus, a simplified nutritional change seems to be more appropriate in order to achieve a long-lasting influence on school children's headache. Methods Therefore, a randomized study was started to investigate the efficacy of a longer lasting nutritional intervention in children with headache, comparing the effects of a self-help brochure to those of individual nutritional advice. Children (7–18 years) with migraine, tension-type headache or a combination of both were randomized into two groups: “self-help program with a brochure” or “individual nutritional advice”. Nutritional change according to Traditional Chinese Medicine as well as state of the art in modern nutritional chemistry included avoidance of milk, curd cheese, wheat flour, white sugar, chocolate, preservatives, coloring and other food additives. After 12 weeks of nutritional change, mitigation of headache was checked in a control appointment. A reduction of headache frequency and intensity in the range of 50 % or more as revealed in headache calendars was defined as success. Results Out of 117 randomized participants, 32 (27 %) suffered from lactose malabsorption. 25 patients failed to fulfil the introduction criteria or broke off, showing a slightly higher but not significant dropout rate in the self-help group. 76 of the remaining participants changed their nutritional habits. 59 (83 %) reported subjective improvement, 56 of which fulfilled the success criteria with no statistically significant difference between the two groups. No significant difference was found between tension type headache and migraine. Conclusion Not only migraine but also tension-type headache responded in a relevant dimension to nutritional treatment. In case of higher migraine frequency combined with allergic comorbidity the efficacy of the nutritional regime seems to be even more pronounced. Personal counseling shows only a trend towards better clinical results. The lacking statistical difference between the two treatment groups excludes a significant importance of personal influence as explanation of headache improvement. In daily counselling, a combination of written information and a short personal explanation seems to be a practicable procedure.

Impact of headache on young people in a school population

Headache is the most frequent neurological symptom and the most common manifestation of pain in childhood. Estimates of the prevalence of headache in children and adolescents vary widely (depending on the setting, methodology, and diagnostic criteria applied) and the impact is not well understood. To quantify the impact of headache in a school population. A questionnaire survey. Exeter schools. A total of 1037 school children between the ages of 12 and 15 years were surveyed, of whom 49% were female. Main outcome measures were headache frequency, disease-specific impact using the Pediatric Migraine Disability Assessment Score (PedMIDAS), and generic quality of life impact using the Pediatric Quality of Life Inventory (PedsQL4). Twenty per cent of the study population had headache one or more times a week, with an average PedMIDAS score of over 12.1 (and an impact on over 12 days in a 3-month period). Ten per cent of the population had a PedMIDAS score of 16.8 and a PedsQL4 generic quality of life score of 70.1, indicating a poorer quality of life than that of children with asthma, diabetes, or cancer. An average of 0.6 days of school was lost in a 3-month period across all school children. There is a significant impact of headache on the quality of life of children. This impact is both unrecognised and unmet. GPs have an important role in identification and management of this problem.

Headache in Pediatric Patients With Celiac Disease and Its Prevalence as a Diagnostic Clue

To establish the prevalence of headache in children with celiac disease (CD), the response to a gluten-free diet, and the prevalence of CD in children affected by headache. This hospital-based study included 2 steps. In the retrospective part, 354 children with CD answered a questionnaire investigating the presence of headache before and after the gluten-free diet. The same questionnaire was administered to 200 healthy children matched for sex and age. In the prospective part, 79 children affected by headache were screened for CD by antitransglutaminase IgA. Diagnosis of CD was confirmed by duodenal biopsy; before starting a gluten-free diet patients underwent a brain positron emission tomography study. After 6 months of follow-up children were reevaluated for the presence of headache. Overall, 88 patients with CD complained of headaches before the diagnosis of CD as compared with 16 in the control group (24.8% vs 8%, P < 0.001). After the institution of a gluten-free diet, the headaches significantly improved in 68 children (77.3%), of whom 24 (27.3%) were headache-free during the study period. Four of 79 (5%) headache patients were found to have CD compared with 0.6% of the general population (P = 0.005). The brain positron emission tomography studies did not show any anomalies. During the follow-up, headaches improved in all 4 children with CD. We recorded -- in our geographical area -- a high frequency of headaches in patients with CD and vice versa with a beneficial effect of a gluten-free diet. Screening for CD could be advised in the diagnostic work-up of patients with headache.

Self-Report of Headache in Children and Adolescents in Germany: Possibilities and Confines of Questionnaire Data for Headache Classification

The aim of this study was to estimate prevalence rates of different types of primary headache in 9- to 14-year-old children in a population-based sample. Case definition was based on International Classification of Headache Disorders (ICHD) criteria. The possibility of implementing these criteria within a questionnaire format, which has been regarded as problematic by some authors, was the main focus of the study. A questionnaire was sent to children and adolescents in 6400 randomly drawn families in southern Lower Saxony. Valid questionnaires were returned by 61.1% of the sample. The overall prevalence rate for tension-type headache (TTH) (criteria C and D) was 17.6% and for migraine (criteria B, C and D) 13.1%. Despite the use of abridged criteria for headache classification, 35.5% of all children reported headache that could not be classified using the ICHD criteria. The response behaviour of these children indicated that they had difficulties reporting symptoms that were defining for migraine or TTH. The classifiability of headache does not seem to be dependent on age or frequency of headache, but rather on the number of 'I don't know' answers given regarding headache characteristics. It is likely that studies reporting prevalence rates that are limited to migraine and or TTH diagnoses underestimate the true prevalence of headache in children and adolescents.

Headache in paediatric patients with celiac disease and its prevalence as a diagnostic clue

Objectives. To establish the prevalence of headache in children with celiac disease (CD) and the response to a gluten-free diet, the prevalence of CD in children affected by headache and the presence of cerebral blood flow abnormalities in headache patients with CD.

Headache in Sickle Cell Disease

The prevalence of frequent headache in children with sickle cell disease (SCD) compared to that of control subjects without known sickle cell trait, and the cause of the headaches were studied at the Children’s Hospital of Philadelphia, PA, and Duke University Medical Center.

Stress in children: how fifth‐year pupils experience stress in everyday life

In many cases, stress in children takes the form of psychosomatic symptoms. The prevalence of headache in children has increased, as has stomach pain and self-reported psychological problems. Many children also experience stress without exhibiting any symptoms, as children perceive, understand and evaluate stress in a variety of different ways. The aim of this study was to describe how fifth-year pupils experience stress in everyday life. An explorative and descriptive design based on phenomenology was chosen to investigate children's lifeworld and lived experience of the phenomenon of stress. The data analysis was based on Giorgi's method. The study comprised 29 children, who were interviewed regarding their experience of stress in everyday life. The results revealed five key constituents: 'fear of being late', 'not having sufficient time', 'physical and mental consequences', 'both a negative and a positive feeling' and 'experiencing significant others' stress'. Together, these key constituents form the overall result. This study demonstrates that stress is a part of children's everyday life. The children described stress that was often acute and linked to situations that occur in everyday life. The results can assist in identifying the factors behind the stress experienced by children. This in turn will facilitate observation and intervention when a child exhibits stress symptoms.

Self‐reported headache in schoolchildren: Parents underestimate their children's headaches

Most previous studies of childhood headache have used indirect parental/physician reports to estimate the prevalence of headache in children. To use direct information from children and to compare the results with data collected from parents. A cross-sectional questionnaire was sent to parents of 7-12-y-olds in Oslo, Norway. The questionnaire included retrospective reports by the parents of the presence of headache among their children during the past 6 mo. A panel study was subsequently done with daily diaries completed by the children over 6 wk. This was done at school. For 2126 children, both diary reports and parental reports were available. We found a 1-mo prevalence of self-reported headache of 57.6%. Parents, particularly fathers, reported lower headache prevalence than the children. The difference between parental reports and those of the children was larger when the child was a girl. There was a clear difference for the youngest children and parental underreporting for children with the most frequent headaches. Since indirect parental reports of child headache underestimated headache frequency compared to direct diary-based self-reports, we suggest more widespread use of diary registration of headaches in studies of child headache.

Prevalencia de cefalea en una población de enfermos celíacos

Headache is the commonest clinical symptom during childhood and adolescence, from a neurologist s point of view. The pathophysiology of migraine and tension headache involve personality and biochemical factors, such as serotonin, which are also common in coeliac disease. To establish the prevalence of headache in children and adolescents with coeliac disease, and any possible relation between these conditions. We made a randomized selection of 86 patients with coeliac disease. All were on gluten-free diets and had no current gastroenterological symptoms. They had direct interviews and full physical and neurological examinations. The diagnosis of headache was based on criteria of the International Headache Society in 1988. The average age was 12.71 +/- 4.5 years (range 5-24). Headache occurred in 34 (39.5%) of the 86 patients studied. In 18 cases (20.9%) headache was of tension type and in 16 (18.6%) of migraine type. Of the latter, 10 cases had auras and 6 did not. There was no significant sex difference. An increased prevalence of both migraine and tension headaches was observed in the coeliac patients studied as compared with data published in the literature. In the former patients there was also a lower frequency in histories of migraine in first degree family members. This data is probably related to the personality of the patient or to his family or social circumstances in the case of tension headaches. In the case of migraine it may be due to biochemical factors such as a lowered plasma serotonin, seen both in coeliac disease and in migraine.