Chronic Daily Headache in Childhood and Adolescence: Clinical Aspects and a 4-Year Follow-up

The prevalence and the clinical features of chronic daily headache (CDH) were studied in 968 children and adolescents observed during a period of one year in the Headache Centre of the Anna Meyer Paediatric Hospital of Florence. Nine hundred and fortyfour patients (97.52%) had primary headache according to ICHD-II, 24 subjects had secondary headache and 56 patients had CDH (5.93% of primary headaches). The mean age of subjects with CDH was higher than general (13.5 vs. 11.5 years), with a female preponderance (69.6% vs. 30.4%). According to the ICHD-II, headaches were classified as chronic migraine in 10 patients (1.5.2 ICHD-II), chronic tension-type headache in 36 (2.3 ICHD-II), new daily persistent headache in 8 (4.8 ICHD-II) and 2 patients reported mixed pattern (chronic migraine+chronic tension type headache). Medication overuse was not implicated in our patients.

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“…Further follow-up studies are necessary to improve knowledge, treatment and outcome of CDH in children and adolescents [15].…”

Section: Discussionmentioning

confidence: 99%

Chronic daily headache in a paediatric headache centre

Scalas

Calistri

2005

J Headache Pain

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“…11,14,15,17,19,20,27,32 The provisos for the diagnosis of any of the primary headache disorders include the caveat: "History and physical and neurological examinations do not suggest any of the disorders listed in groups 5-12…or (such disorders are) ruled out by appropriate investigations…" 32 Four issues that are the subject of continuing debate will be discussed.…”

Section: Classification Of Cdhmentioning

confidence: 99%

Chronic Daily Headache in Children and Adolescents: A Multi-Faceted Syndrome

Seshia

Wang

Abu‐Arafeh

et al. 2010

Can. j. neurol. sci.

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In 1982, Mathew et al first used the term "chronic daily headache" (CDH) to describe headaches that occurred almost daily in adults. 1 Twelve years later, Holden et al published the first report on children with CDH. 2 Since then, there have been at least 21 reports globally. Cumulative knowledge suggests that CDH is not only a common chronic pain syndrome in children (the term will be used to include adolescents), but also a multi-faceted, and often complex one. The appreciation of the many aspects of CDH is pivotal to clinical research and management, and is the thrust of our review. DEFINITIONS AND CLASSIFICATION: THE CONTINUING CONTROVERSY BackgroundIn the almost 30 years since the original description, CDH continues to evoke passionate debate. Globally accepted criteria ABSTRACT: Chronic daily headache (CDH) is a multi-faceted, often complex pain syndrome in children and adolescents. Chronic daily headache may be primary or secondary. Chronic migraine and chronic tension-type are the most frequent subtypes. Chronic daily headache is co-morbid with adverse life events, anxiety and depressive disorders, possibly with other psychiatric disorders, other pain syndromes and sleep disorders; these conditions contribute to initiating and maintaining CDH. Hence, early management of episodic headache and treatment of associated conditions are crucial to prevention. There is evidence for the benefit of psychological therapies, principally relaxation and cognitive behavioral, and promising information on acupuncture for CDH. Data on drug treatment are based primarily on open label studies. The controversies surrounding CDH are discussed and proposals for improvement presented. The multifaceted nature of CDH makes it a good candidate for a multi-axial classification system. Such an approach should facilitate biopsychosocial management and enhance consistency in clinical research.RÉSUMÉ: La céphalée quotidienne chronique chez les enfants et les adolescents, un syndrome à multiples facettes. La céphalée quotidienne chronique (CQC) est un syndrome douloureux à multiples facettes qui est souvent complexe chez les enfants et les adolescents. La céphalée quotidienne chronique peut être primaire ou secondaire. La migraine chronique et la céphalée de tension chronique sont les sous-types les plus fréquents. La CQC est une comorbidité des incidents fâcheux de la vie, de l'anxiété et des troubles dépressifs, possiblement liée à d'autres troubles psychiatriques, syndromes douloureux et troubles du sommeil. Ces états contribuent à amorcer et à maintenir la CQC. Le traitement précoce de la céphalée épisodique et le traitement des comorbidités est donc crucial pour la prévention. Certaines données démontrent un bénéfice des psychothérapies, principalement de la relaxation et de la thérapie cognitivo-comportementale, et l'acuponcture pour le traitement de la CQC semble prometteuse. Les données sur le traitement médicamenteux sont basées principalement sur des études ouvertes. Nous discutons des controverses entourant la CQC et des mo...

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“…Smoking and alcohol intake have been considered as risk factors for relapsing of medication overuse headache in a longitudinal study 19 . In the pediatric population, age of onset and severity of migraine 4 , as well as psychiatric comorbidities 6 have been associated with CDH. The interface between biological predisposition and exposure is exemplified in an adolescent study.…”

Section: Overviewmentioning

confidence: 99%

“…They asked: [1] If the mother received prenatal care; [2] If the mother smoked during pregnancy; [3] If the father or other individuals leaving with the mother smoked during her pregnancy; [4] Maternal alcohol use during pregnancy; [5] Illicit drug use during pregnancy; [6] Hypertension during pregnancy; [7] Length of pregnancy; [8] Type of delivery (vaginal, cesarean, other).…”

Section: Pregnancy Antecedentsmentioning

confidence: 99%

“…Additionally, when contrasted to adults, adolescents with chronic daily headache (CDH) were more likely to have developed the disease without exposure to environmental risk factors (e.g. medication overuse) [4][5][6] . Increased vulnerability of pediatric subpopulations to certain diseases may reflect a combination of stronger biological predisposition, pre-natal exposures, or early life exposures/comorbidities 7 .…”

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confidence: 99%

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Prenatal exposure to tobacco and alcohol are associated with chronic daily headaches at childhood: A population-based study

Arruda¹,

Guidetti

Galli

et al. 2011

Arq. Neuro-Psiquiatr.

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The influence of prenatal events on the development of headaches at childhood has not been investigated and is the scope of our study. Of 2,173 children identified as the target sample, consents and analyzable data were provided by 1,440 (77%). Parents responded to a standardized questionnaire with a validated headache module and specific questions about prenatal exposures. Odds of chronic daily headache (CDH) were significantly higher when maternal tabagism was reported. When active and passive smoking were reported, odds ratio (OR) of CDH were 2.29 [95% confidence intervals (CI)=1.6 vs. 3.6)]; for active tabagism, OR=4.2 (95% CI=2.1-8.5). Alcohol use more than doubled the chance of CDH (24% vs. 11%, OR=2.3, 95% CI=1.2-4.7). In multivariate analyses, adjustments did not substantially change the smoking/CDH association. Prenatal exposure to tobacco and alcohol are associated with increased rates of CDH onset in preadolescent children. Key words: headache, migraine, childhood, prenatal exposure, tobacco, alcohol.Tabagismo e ingestão alcoólica pré-natal estão associados à cefaleia crônica diária na infância: um estudo de base populacional RESUMO A influência de eventos pré-natais na fisiopatogenia das cefaleias na infância ainda não foi investigada e é o objetivo desse estudo. Da amostra-alvo de 2.173 crianças, um consentimento pós-informado e dados suficientes para as análises foram obtidos de 1.440 (77%). Os pais responderam a um questionário padrão com um módulo de cefaleia validado na população brasileira e questões específicas sobre antecedentes pré-natais. O risco de cefaleia crônica diária (CCD) foi significativamente maior nas crianças cujas mães fumaram durante a gestação. Quando presentes tabagismo ativo e passivo, o risco (OR) de CCD foi de 2,29 [intervalo de confiança (IC) de 95%=1,6-3,6)]; para tabagismo ativo, OR=4,2 (IC 95%=2,1-8,5). O uso de álcool durante a gestação dobrou o risco de CCD (24% vs. 11%, OR=2,3, IC 95%=1,2-4,7). Nas análises multivariadas, os ajustes não modificaram, substancialmente a associação entre tabagismo materno durante a gestação e CCD. A exposição pré-natal ao tabaco e ao álcool encontra-se associada à CCD de início na infância. Palavras-chaves: cefaleia, enxaqueca, migrânea, infância, tabaco, álcool. The epidemiology of frequent headaches in the pre-adolescent pediatric population is poorly known, but limited evidence suggests that headaches on more than 10 days per month happen in over 4% of this population 1 . This relatively high

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Chronic Daily Headache in Childhood and Adolescence: Clinical Aspects and a 4-Year Follow-up

Cited by 69 publications

References 43 publications

Chronic daily headache in a paediatric headache centre

Chronic daily headache in a paediatric headache centre

Chronic Daily Headache in Children and Adolescents: A Multi-Faceted Syndrome

Prenatal exposure to tobacco and alcohol are associated with chronic daily headaches at childhood: A population-based study

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