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IHC: Chronic Daily Headaches in Children Different From That in Adults By Larry Schuster ROME, ITALY -- September 30, 2003 -- Two studies on chronic daily headaches suggest some differences in the way those headaches appear in children compared to adults, researchers revealed here September 14th at the 11th Congress of the International Headache Society (IHS). In one study, principal author Martine C.M. van der Geest, MD, Leiden University Medical Center, Leiden, Netherlands, reported on 79 children with chronic daily headaches, mean of 11 years of age (range 3 to 15). The researchers studied the clinical features of the chronic daily headaches in these children to assess the applicability of 1988 criteria of the International Headache Society classification. The IHS released its updated criteria at the 11th congress. The researchers found that 24.1% of the children met the 1988 criteria for chronic daily headache. Duration ranged from 1 to 4 hours for 9%, and from 4 hours to an entire day for 60% of the children. Exercise was an aggravating factor in a quarter of the patients. About half of the children used analgesic agents, but 19% took them daily. That rate is lower than what has been seen in adults with chronic daily headaches, according to Julio Pascual, MD, PhD, Marques de Valdecilla, Santander, Spain. Dr. Pascual, who summarized that day's most significant presentations for the Congress, said that these findings show that chronic daily headaches in children are not necessarily linked to analgesic consumption. The new IHS classification emphasizes the role of drug overuse in the development of chronic headaches. In a second study, presented by Kenneth Mack, MD, PhD, Mayo Clinic, Rochester, Minnesota, United States, researchers identified the initiating factors in the development of new daily persistent headache in children. Of 163 children with chronic daily headache, 25% were diagnosed with new daily persistent headache. They had no significant prior headache history. Commenting on this finding, Dr. Pascual said, "I would like to emphasise [that] a lot of these children with chronic daily headache -- contrary to what we see in adults -- suffer from new daily persistent headache. This is not the same as we see in adults." Among the factors associated with onset of the new daily persistent headache in this population were: -- 36% had onset of their symptoms during a viral infection, and 60% of those had Epstein-Barr virus -- About 20% had head injuries, usually minor, at the onset of the headache, yet had a normal neurological exam and neuro-imaging test results -- Symptoms for 3.8% of children were associated with surgery -- Onset of headaches for 1.3% of patients was associated with high-altitude camping -- 5.1% of the patients with new daily persistent headache were initially identified as having idiopathic intracranial hypertension, although their hypertension persisted despite normalization of their intracranial pressure. Dr. Mack concluded, "In children, the onset of new daily persistent headache is strongly associated with physiologic stress such as a viral infection, head trauma or [surgery]." [Study title: What Causes New Daily Persistent Headache in Children? Abstract P2C15] E-mail this page to a friend or colleague! To print, use this version