AIM The aim of this study was to review systematically the prevalence of headache and migraine in children and adolescents and to study the influence of sex, age, and region of residence on the epidemiology.METHOD We systematically searched the literature in electronic databases to cover the period between 1 January 1990 and 31 December 2007. We assessed and included population-based studies on epidemiology of headache and migraine in children and adolescents if they fulfilled the following criteria: (1) reporting on unselected childhood population; (2) reliable methods of data collection using a questionnaire or face-to-face interviews; (3) using the International Headache Society's (IHS) criteria (1988 or 2004) for the diagnosis of migraine; and (4) provision of sufficient and explicit data for analysis. We used Excel, Stata, and Confidence Interval Analysis software. RESULTSWe identified and analysed 50 population-based studies reporting the prevalence of headache and ⁄ or migraine in children and adolescents (<20y). The estimated prevalence of headache over periods between 1 month and lifetime in children and adolescents is 58.4% (95% confidence interval [CI] 58.1-58.8). Females are more likely to have headache than males (odds ratio [OR] 1.53, 95% CI 1.48-1.6). The prevalence of migraine over periods between 6 months and lifetime is 7.7% (95% CI 7.6-7.8). Females are more likely than males to have migraine (OR 1.67, 95% CI 1.60-1.75). Regional differences in prevalence of migraine, though statistically significant, may not be of clinical significance. The change in the IHS's criteria for the diagnosis of migraine was not associated with any significant change in the prevalence of migraine.INTERPRETATION This study confirms the global high prevalence of headache and migraine in children and adolescents. Sex, age, and regional differences are evident.Childhood headache has an important adverse impact on the child and the family, as shown in many studies, including a recent review. 1 Therefore an accurate estimate of the true prevalence derived from all published world literature will help in assessing the magnitude of the problem, streamlining resources in improvement of diagnosis and treatment, and reducing its burden.The prevalence of childhood headache and migraine has been reported from across the world with widely variable estimates of prevalence. Since the publication of the International Headache Society's (IHS) Classification and Diagnosis of Headache Disorders 2 in 1988 and the second edition of the International Classification of Headache Disorders 3 in 2004 (ICHD-II), there have been several published studies that share common methods and criteria for the diagnosis of migraine. These allow a systematic review of the world literature, despite some inevitable minor variations in methods such as the use of a questionnaire, face-to-face interviews, or both in collecting data, point-in-time prevalence, and reporting on different age groups within the childhood population. A degree of heterogeneity is, ...

Recurrent instability and deficits of shoulder function are common after primary nonoperative treatment of an anterior shoulder dislocation. There is substantial variation in the risk of instability, with younger males having the highest risk and females having a much lower risk. Future clinical trials to evaluate primary interventions should evaluate the prevalence of recurrent instability and functional deficits, with use of an assessment tool specifically for shoulder instability, during the first two years after the initial dislocation.

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