Symptoms associated with headache in youth

Abstract

Objective To determine the underlying relationships between a broad range of headache-associated symptoms and how they relate to headache burden. Background Symptoms associated with head pain inform classification of headache disorders. However, many headache-associated symptoms are not included in the diagnostic criteria, which is largely based on expert opinion. Large symptom databases can assess headache-associated symptoms irrespective of pre-existing diagnostic categories. Methods We conducted a large single-center cross-sectional study on youth (6–17 years old) assessing patient-reported outpatient headache questionnaires between June 2017 and February 2022. Multiple correspondence analysis, an exploratory factor analysis, was applied to 13 headache-associated symptoms. Results 6662 participants (64% female; median age 13.6 years) were included. Multiple correspondence analysis dimension 1 (25.4% of the variance) captured the absence or abundance of headache-associated symptoms. A greater number of headache-associated symptoms correlated with greater headache burden. Dimension 2 (11.0% of the variance) revealed three symptom clusters: (1) cardinal features of migraine (light, sound, and smell sensitivity, nausea, and vomiting), (2) nonspecific global neurologic dysfunction symptoms (lightheadedness, trouble thinking, blurry vision), (3) vestibular and brainstem dysfunction symptoms (vertigo, balance problems, ear ringing, double vision). Conclusion Assessing a broader range of headache-associated symptoms reveals clustering of symptomatology and a strong relationship with headache burden.

Patient headache questionnaires can improve headache diagnosis and treatment in children

“…This is the primary analysis of these data, though we have used the database for a separate analysis of patient‐reported headache features 27 . No statistical power calculation was conducted; the sample size was based on available data.…”

“…This is the primary analysis of these data, though we have used the database for a separate analysis of patient-reported headache features. 27 No statistical power calculation was conducted; the sample size was based on available data. headache types as outlined in the ICHD-3 28 : migraine, chronic migraine, trigeminal autonomic cephalalgias (TAC, including hemicrania continua, paroxysmal hemicrania, and cluster headache), TTH, post-traumatic headache (PTH), and other primary headache disorders (including new daily persistent headache, primary stabbing headache, occipital neuralgia) versus headache NOS (784.0 or R51).…”