Headache in a National Sample of American Children: Prevalence and Comorbidity

Abstract

The purpose of this study was to determine the prevalence, sociodemographic correlates, and comorbidity of recurrent headache in children in the United States. Participants were individuals aged 4 to 18 years (n = 10 198) who participated in the National Health and Nutrition Examination Surveys. Data on recurrent and other health conditions were analyzed. Frequent or severe headaches including migraine in the past 12 months were reported in 17.1% of children. Asthma, hay fever, and frequent ear infections were more common in children with headache, with at least 1 of these occurring in 41.6% of children with headache versus 25.0% of children free of headache. Other medical problems associated with childhood headaches include anemia, overweight, abdominal illnesses, and early menarche. Recurrent headache in childhood is common and has significant medical comorbidity. Further research is needed to understand biologic mechanisms and identify more homogeneous subgroups in clinical and genetic studies. Keywordsheadache; migraine; comorbidity; prevalence Headache is a common complaint in children and adolescents. The most frequent type of recurrent headache in young children is migraine, 1 while the frequency of tension type headache increases in the later years of childhood. Recurrent headaches can negatively impact a child's life in several ways, including school absences, decreased academic performance, social stigma, and impaired ability to establish and maintain peer relationships. The quality of life in children with migraine is impaired to a degree similar to that in children with arthritis or cancer. 2 There has been limited population-based research on headache and migraine in children, particularly in the United States. Most of our knowledge regarding the prevalence and demographic correlates of migraine is derived from school-based questionnaire studies in European countries [3][4][5][6] and some from the United States. 7,8 Prevalence estimates for headache in prepubertal children range from 2.4% to 17% for migraine and 4% to 5% for frequent or severe headache. For the postpubertal ages estimates are considerably higher, ranging from NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript 5% to 18% for migraine and 9% to 29% for other frequent or severe headaches. Despite the impact of headache on pediatric health, only 1 population-based American study to date has examined the frequency of recurrent headache in children. 9 Individuals who suffer from migraine or severe headaches are also diagnosed with certain other medical conditions at a higher than expected frequency. Comorbidity can significantly influence the delivery of medical care as it may confound diagnosis and provide special therapeutic challenges. No population-based study to date has systematically examined the patterns of medical comorbidity of recurrent headache or migraine in childhood. Knowledge of other biologic systems involved would not only help physicians provide better care for their patients but may also ...

Migraine and preterm birth

“…19 There is evidence that migraine is associated with markers of inflammation, such as elevated C-reactive protein and of homocysteine, 20 (although that evidence is not unambiguous 21 ) and in children with elevated levels of certain cytokines, 22 and with disorders such as asthma that have an inflammatory component. 1 Migraine and pre-eclampsia Since 1959, reports have associated migraine with approximately a doubling of risk of pre-eclampsia. 23,11 The Sanchez study used standardized criteria, as most previous studies had not, and in that study the association of migraine with pre-eclampsia was attenuated and no longer significant after adjustment for maternal age, parity and pre-pregnancy adiposity.…”

Headache in Children and Adolescents

“…Other medical problems associated with childhood headaches include atopic disorders (asthma, rhinitis or eczema), hay fever, frequent ear infections, anemia, hyperactive/impulsive behaviour, learning disabilities, stuttering, abdominal illnesses and bowel disease, enuresis, celiac disease, early menarche, and cardiovascular disease, especially ischemic stroke and patent foramen ovale (PFO) [1,61,[73][74][75][76][77][78] .…”

“…Other prophylactic medicines are topiramate, valproic acid, levetiracetam, gabapentin, lamotrigine, zonisamide, pregabalin, cyproheptadine, and propranolol [2,87,[89][90] . Among these, only topiramate is approved by FDA, in adolescents 12-17 years of age [91] .Neutraceuticals including riboflavin, coenzyme Q10, butterbur and magnesium showed some efficacy [1,[92][93][94] . Onabotulinumtoxin A is FDA-approved medication for a chronic migraine in adults and showed improvement in disability scores and headache frequency in pediatric chronic daily headache patients and in pediatric chronic migraine [95] .…”

“…Primary headaches (especially migraine and tension-type headache (TTH)) are the most important cause of headaches in children and adolescent. It has detrimental effects on the child"s academic performance, cognitive profile, and interpersonal relationships; and associated with personal and societal burdens of pain, disability, damaged quality of life and immense economic losses [1][2][3][4][5] .…”

Ectopia amigdalina cerebelosa borderline en un niño con cefalea. Caso clínico

“…1 Aunque el tipo más frecuente de cefalea recurrente en los niños pequeños es la migraña, las personas que sufren de cefaleas también son diagnosticadas de ciertas afecciones con una frecuencia mayor que la esperada. 2,3 En un análisis transversal de los pacientes con cefalea no aguda que fueron derivados a una clínica de neurología infantil, 46% tenían estudios por imágenes del sistema nervioso central, y de estos pacientes, más de una quinta parte tenían hallazgos incidentales, como malformación de Chiari I, quistes aracnoideos y anomalías del desarrollo venoso. 4 La ectopia amigdalina cerebelosa borderline (EACB) es una de estas entidades y se puede definir como la protrusión de las amígdalas cerebelosas a <5 mm por debajo del agujero magno.…”