Unusual headache syndromes in children

Abstract

Headaches represent one of the most common reasons why children and adolescents seek medical attention and are the primary reason that they are referred to pediatric neurology practices. The most common headache syndromes diagnosed are migraine, tension-type, and chronic daily headache, and the bulk of recent medical literature regarding headache in children has focused on these clinical entities. Children are prone to have unusual headache syndromes, most of which fall under the category of "primary headache," most notably as manifestations of migraine with aura. Included within this group are basilar-type and hemiplegic migraine. The most intriguing subset included in the International Headache Society's classification system is the so-called "periodic syndromes of childhood that are precursors to migraine." These syndromes, quite peculiar to children, present a wide variety of episodic symptoms, including movement disorders, vomiting, ataxia, and vertigo, and may not include headache at all. This article provides an overview of some of the more unusual headache syndromes in children and adolescents.

Ataxia

“…These constitute the basis of the clinical approach (Flaherty, 2000;Ryan and Engle, 2003;Subramony, 2004;Blasetti et al, 2007;Brenner et al, 2007;Bernard and Shevell, 2008;Dimova et al, 2009), and initially help characterize the presentation of the ataxia as acute, episodic, subacute, or progressive as this method will help one develop a differential diagnosis. For instance, a history of trauma and in particular toxic ingestion and the medications available to the child should be elicited when considering a child with acute ataxia.…”

Urinary leukotriene E4 and prostaglandin F2a concentrations in children with migraine: a randomized study

“…Headache is a common complaint in children, with a prevalence of 37–51% at age 7 years increasing to 57–82% during adolescence . Although epidemiological studies have demonstrated that migraine is the most common type of headache in this age group, the exact pathophysiology of the disease remains unclear, although it may be associated with sterile neuroinflammation.…”

The Frequent Unusual Headache Syndromes: A Proposed Classification Based on Lifetime Prevalence

“…First, we shall discuss the concept of “unusual headache syndromes” as a group of headache disorders, a nomenclature increasingly used in the literature and found in PubMed (Title/Abstract) since 1998, also referred to as “rare headache syndromes” or “uncommon headache syndromes.” Conversely, the term “unusual headache syndrome” is occasionally used to refer to a specific case, particularly for the purpose of grouping a constellation of characteristic symptoms regularly seen in a small group of patients (usually published in the form of case reports), which may suggest an individual headache entity or a group of headache disorders with a common pathophysiology.…”