Clinic-based characterization of continuous headache in children and adolescents: Comparing youth with chronic migraine to those with new daily persistent headache

Abstract

Objective To describe the headache characteristics and functional disability of a large sample of treatment-seeking youth with continuous headache and compare these factors across diagnostic subgroups of chronic migraine and new daily persistent headache. Methods This retrospective study utilized clinical information (e.g. diagnosis, headache features, medication overuse, functional disability) from a large data repository of patients initially presenting to a multidisciplinary headache center with continuous headache. Patient inclusion in subgroup analyses for chronic migraine and new daily persistent headache was based on clinician diagnosis using International Classification of Headache Disorders (ICHD) criteria. Results The current sample included 1170 youth (mean age = 13.95 years, 78.8% female) with continuous headache. The overwhelming majority of these youth had headaches with migrainous features, regardless of their clinical diagnosis. Youth with chronic migraine reported a longer history of continuous headache symptoms and earlier age of headache onset than youth with new daily persistent headache and were more likely to have medication overuse. Most youth with continuous headache experienced severe migraine-related functional disability, regardless of diagnostic subgroup. Conclusions Overall, youth with continuous chronic migraine and new daily persistent headache did not have clinically meaningful differences in headache features and associated disability. Findings suggest that chronic migraine and new daily persistent headache may be variants of the same underlying disease.

Features and Management of New Daily Persistent Headache in Developmental-Age Patients

“…In our cohort, 73% of patients reported headache characteristics similar to those of migraine. This is consistent with prior studies showing that paediatric patients with NDPH have a migrainous phenotype of their headache [4]. However, when compared to patients with chronic migraine, our NDPH patients were less often referred with nausea and vomiting.…”

“…Moreover, at paediatric age, chronic headaches often show a seasonal cyclical pattern, which has been related to school activities [10][11][12]. In paediatric NDPH, the hypothesis has been made that the onset can fall in the months when children start or return to school [4,11,13]. In our NDPH patients, stressful school activity was a frequently recognized trigger event (46% of patients).…”

“…In the literature, there are clinical studies conducted on the adult population that describe the characteristics of pain and the presence of any trigger factors [2,3]. Far fewer are the paediatric pooling studies with NDPH [4,5]. Furthermore, especially for what concerns the therapeutic management of NDPH, to date, we have conclusive information.…”

Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication-overuse headache: A double-center retrospective study

“…The clinical characteristics of the NDPH in our study were bilateral localization, nonthrobbing nature, and a typical lack of association with nausea and vomiting; these characteristics were similar to those of chronic tension type headache in many cases. However, other summarized literature demonstrated the presence of migraine-like features in NDPH patients, with a proportion of 35-64.1% (8,9,(11)(12)(13). NDPH typically occur in individuals without a prior headache history (1).…”

“…MOH accounts for 11-70% of the patients with CDH [6],and epidemiology data from China accounts for 60% of patients with CDH [7]. Although there was a previous study comparing chronic migraine (CM) with NDPH [8], the enrolled participants were children and adolescents, and there is a lack of studies in adult patients. NDPH and MOH are two different types of headaches that have signi cantly different prevalence in CDH.…”