Chronic Daily Headache in Children and Adolescents Presenting to Tertiary Headache Clinics

Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. Objectives : To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Method : Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Results : Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001). Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001). Conclusion : TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

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“…Thus, further studies should focus on the relationship between TMD and TTH. In another clinic-based study, findings were similar to ours 29 .…”

Section: Discussionsupporting

confidence: 88%

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

Júnior¹,

Brandão

Faleiros

et al. 2014

Arq. Neuro-Psiquiatr.

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“…1,[6][7][8]11,12,17,18,20 In a community based study of 12 to 14-year-old school children, almost half of the 121 subjects with CDH had at least one psychiatric disorder; depressive disorders were found in 30% (36 of 121) and anxiety disorders in 36% (43 of 121); additionally 20% (24 of 121) had high "current" suicidal scores. 18 These figures were much higher than those in the age matched general population.…”

Section: Anxiety and Depressive Disordersmentioning

confidence: 99%

“…Transformation occurred in 78% of 630 patients in the series of Mathew et al 35 A similar percentage has been reported in children. 6,8,10,20 Chronic migraine, CTTH, mixed CM and CTTH, in variable proportion, have constituted the most frequent subtypes of primary CDH in clinic based studies. 3,[5][6][7][8][9][10][11][12]16,19,20 In an adolescent community based study, the relative frequencies for CM and CTTH were 7% and 66% respectively (N=122) but 59% of those with CTTH also had migraine attacks.…”

Section: Primary Subtypes (Codes 1-4)mentioning

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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“…Of these patients, NDPH is diagnosed more frequently in children and adolescents than in adults [6]. NDPH has been estimated to occur in 1.7% to 10.8% of adults with CDH [14,15], and in 13% to 35% of children with CDH [16][17][18]. It is more common in females, with the female/male ratio in adults at 2.5:1 [5] and in children and adolescents at 1.8:1 [4•].…”

Section: Epidemiologymentioning

confidence: 99%

New Daily Persistent Headache in Children and Adolescents

Baron

Rothner

2010

Curr Neurol Neurosci Rep

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New daily persistent headache (NDPH) is a form of chronic daily headache (CDH) that may have features of both migraine and tension-type headache. In contrast with other types of CDH, NDPH is characterized by patients recalling the specific date their unremitting daily headache began. In comparison, chronic tension-type headache and chronic migraine are preceded by a gradually increasing frequency of headache. After several months, all three of these CDH forms often have a similar phenotype, making early history a key to diagnosing NDPH. Evaluations to exclude secondary causes are necessary but usually negative. NDPH is difficult to treat and requires a multimodal approach. Questions regarding NDPH remain unanswered. Additional prospective studies are necessary to further understand, characterize, diagnose, and treat NDPH.

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Chronic Daily Headache in Children and Adolescents Presenting to Tertiary Headache Clinics

Abstract: Our data suggest that rather than having two coexistent headache types, children and adolescents with chronic daily headache have a single syndrome that, in many cases, will paroxysmally worsen and gather migrainous features.

Cited by 83 publications

References 46 publications

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

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

New Daily Persistent Headache in Children and Adolescents

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