Always on my mind: Headache in children

Munday, Sarah; Rao, Arjun

doi:10.1111/1742-6723.12627

Cited by 6 publications

(5 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After adolescence, hypertension-type headache frequently arises from high blood pressure. [ 12 ] Ninety-eight (53%) of our cases were girls, 87 (47%) were boys, and the mean age was 11.4 years (min–max, 4–17).…”

Section: Discussionmentioning

confidence: 99%

Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache

Çıraklı

2022

Medicine

View full text Add to dashboard Cite

The prevalence of headache in childhood increases due to environmental factors. Various risk factors in children whose playgrounds are restricted outside and therefore remain inactive. So diagnosis and treatment can be challenging. The aim of this study was to evaluate the experience of flunarizine in childhood headache with a focus on efficacy and success. We conducted a retrospective observational study of 185 pediatric patients at the tertiary pediatric emergency and pediatric neurology unit between May 2018 and May 2020. Patients with headache for >15 days of a month for at least 3 months were included in the study, whether or not receiving treatment. Also, all patients who had an adequate follow-up period were included in the study. All patients were evaluated by history, physical–neurological examination, blood tests, blood pressure, eye examination, and cranial magnetic resonance imaging. All data were evaluated statistically. Ninety-eight (53%) of 185 cases were female and 87 (47%) were male. Average age was 11.4 years (min–max, 4–17). There was family history in 51.3% of the cases. The most frequent applicants were in the autumn season (43%), when schools were opened. Organic causes were hypertension in 1 case, brain tumor in 1 case, and papilledema due to idiopathic intracranial hypertension in 2 cases. The other cases were asked to make a 1-month pain chart and grading according to the visual analog scale. In this process, it was stated that painkillers could be used if needed. At the end of the first month, these patients were reevaluated. Flunarizine treatment was initiated in 95 patients who had to use painkillers for >4 times and who described ≥6 pain score according to the visual analog scale. The treatment was discontinued due to sleepiness and weakness in 2 patients. At the end of the third month, a 50% reduction in headache was observed in 82 cases (86.3%). We used flunarizine as the first choice in all patients and we achieved a high rate of treatment success. Flunarizine can be considered as an alternative option for headache management in terms of low side effects, easy accessibility, and compliance with treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache

Çıraklı

2022

Medicine

View full text Add to dashboard Cite

show abstract

“…It is therefore fundamental for the PCP to inspect environmental and family dynamics, school performance, and the presence of psychosocial stressors, as they can be triggering factors of headache in primary or secondary to psychiatric/psychosomatic pathology. Furthermore, screening for alcohol, drug, smoking, smartphone, or video game abuse should be performed in all adolescent patients [34,35].…”

Section: Recommendation 4 (Scenarios 5 and 6)mentioning

confidence: 99%

Pediatric Headache in Primary Care and Emergency Departments: Consensus with RAND/UCLA Method

Prezioso

Suppiej²,

Alberghini³

et al. 2022

Life

View full text Add to dashboard Cite

Headache is the most frequent neurological symptom in childhood and the main reason for admission to pediatric emergency departments. The aim of this consensus document is to define a shared clinical pathway between primary care pediatricians (PCP) and hospitals for the management of children presenting with headache. For the purposes of the study, a group of hospital pediatricians and a group of PCP from the Emilia Romagna’s health districts were selected to achieve consensus using the RAND/UCLA appropriateness method. Thirty-nine clinical scenarios were developed: for each scenario, participants were asked to rank the appropriateness of each option from 1 to 9. Agreement was reached if ≥75% of participants ranked within the same range of appropriateness. The answers, results, and discussion helped to define the appropriateness of procedures with a low level of evidence regarding different steps of the diagnostic-therapeutic process: primary care evaluation, emergency department evaluation, hospital admission, acute therapy, prophylaxis, and follow-up. The RAND proved to be a valid method to value appropriateness of procedures and define a diagnostic-therapeutic pathway suitable to the local reality in the management of pediatric headache. From our results, some useful recommendations were developed for optimizing the healthcare professionals’ network among primary care services and hospitals.

show abstract

“…Household and family dynamics, psychosocial stress factors, and school performance should also be evaluated because they can be precipitating factors in children and adolescents. A HEADSS (home, education, alcohol, drugs, smoking, sex) screen should be performed in all adolescent patients (16).…”

Section: Evaluation Of Headache In Ed: How To Diagnose Headachementioning

confidence: 99%

“…The general physical examination is of extreme importance and must be conducted in a complete manner. The first step is to assess the patient's severity of pain, which may be indicative of a more serious underlying condition (14, 16), further to investigate the clinical features of children presenting to a pediatric ED with headache as the chief complaint and report in their observational study that all patients with LT secondary headache can present very intense pain. One must investigate for important clues leading to the correct diagnosis (skin rash, petechiae, stiff neck, organomegaly).…”

Section: Evaluation Of Headache In Ed: How To Diagnose Headachementioning

confidence: 99%

“…Headache is unusual as an isolated complaint and is most often associated with other symptoms such as fever, sore throat, neck pain, and vomiting (15). The most common recurrent headache in childhood is migraine, while tension headaches prevail in adolescence (16). Males are more frequently affected at preschool age, while incidence is higher in females in junior-high school age (17, 18).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of Childhood Headache in the Emergency Department. Review of the Literature

et al. 2019

View full text Add to dashboard Cite

Headache is the third cause of visits to pediatric emergency departments (ED). According to a systematic review, headaches in children evaluated in the ED are primarily due to benign conditions that tend to be self-limiting or resolve with appropriate pharmacological treatment. The more frequent causes of non-traumatic headache in the ED include primitive headaches (21.8–66.3%) and benign secondary headaches (35.4–63.2%), whereas potentially life-threatening (LT) secondary headaches are less frequent (2–15.3%). Worrying conditions include brain tumors, central nervous system infections, dysfunction of ventriculo-peritoneal shunts, hydrocephalus, idiopathic intracranial hypertension, and intracranial hemorrhage. In the emergency setting, the main goal is to intercept potentially LT conditions that require immediate medical attention. The initial assessment begins with an in-depth, appropriate history followed by a complete, oriented physical and neurological examination. The literature describes the following red flags requiring further investigation (for example neuroimaging) for recognition of LT conditions: abnormal neurological examination; atypical presentation of headaches: subjective vertigo, intractable vomiting or headaches that wake the child from sleep; recent and progressive severe headache (<6 months); age of the child <6 years; no family history for migraine or primary headache; occipital headache; change of headache; new headache in an immunocompromised child; first or worst headache; symptoms and signs of systemic disease; headaches associated with changes in mental status or focal neurological disorders. In evaluating a child or adolescent who is being treated for headache, physicians should consider using appropriate diagnostic tests. Diagnostic tests are varied, and include routine laboratory analysis, cerebral spinal fluid examination, electroencephalography, and computerized tomography or magnetic resonance neuroimaging. The management of headache in the ED depends on the patient's general conditions and the presumable cause of the headache. There are few randomized, controlled trials on pharmacological treatment of headache in the pediatric population. Only ibuprofen and sumatriptan are significantly more effective than placebo in determining headache relief.

show abstract

Always on my mind: Headache in children

Cited by 6 publications

References 13 publications

Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache

Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache

Pediatric Headache in Primary Care and Emergency Departments: Consensus with RAND/UCLA Method

Management of Childhood Headache in the Emergency Department. Review of the Literature

Contact Info

Product

Resources

About