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[Management of chronic daily headache in children and adolescents].
Rev Neurol (Paris) 2009 Jun-Jul; 165(6-7):521-31RN

Abstract

Chronic daily headache (CDH) affects 2 to 4% of adolescent females and 0,8 to 2% of adolescent males. CDH is diagnosed when headaches occur more than 4 hours a day, for greater than or equal to 15 headache days per month, over a period of 3 consecutive months, without an underlying pathology. It is manifested by severe intermittent headaches, that are migraine-like, as well as a chronic baseline headache. Silberstein and Lipton divided patients into four diagnostic categories: transformed migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. The second edition of the International Classification of Headache Disorders did not comprise any CDH category as such, but provided criteria for all four types of CDH: chronic migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. Evaluation of CDH needs to include a complete history and physical examination to identify any possibility of the headache representing secondary headaches. Children and adolescents with CDH frequently have sleep disturbance, pain at other sites, dizziness, medication-overuse headache and a psychiatric comorbidity (anxiety and mood disorders). CDH frequently results in school absence. CDH management plan is dictated by CDH subtype, the presence or absence of medication overuse, functional disability and presence of attacks of full-migraine superimposed. Reassuring, explaining, and educating the patient and family, starting prophylactic therapy and limiting aborting medications are the mainstay of treatment. It includes pharmacologic (acute and prophylactic therapy) and nonpharmacologic measures (biobehavioral management, biofeedback-assisted relaxation therapy, and psychologic or psychiatric intervention). Part of the teaching process must incorporate life-style changes, such as regulation of sleep and eating habits, regular exercise, avoidance of identified triggering factors and stress management. Emphasis must be placed on preventive measures rather than on analgesic or abortive strategies. Stressing the reintegration of the patient into school and family activities and assessing prognosis are other issues to address during the first visit. There are limited data evaluating the outcome of CDH in children and adolescents.

Authors+Show Affiliations

Service de neuropédiatrie, clinique de pédiatrie, hôpital Roger-Salengro, centre hospitalier régional et universitaire de Lille, rue du Professeur-Laine, 59037 Lille cedex, France. jc-cuvellier@chru-lille.fr

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

19041108

Citation

Cuvellier, J-C. "[Management of Chronic Daily Headache in Children and Adolescents]." Revue Neurologique, vol. 165, no. 6-7, 2009, pp. 521-31.
Cuvellier JC. [Management of chronic daily headache in children and adolescents]. Rev Neurol (Paris). 2009;165(6-7):521-31.
Cuvellier, J. C. (2009). [Management of chronic daily headache in children and adolescents]. Revue Neurologique, 165(6-7), pp. 521-31. doi:10.1016/j.neurol.2008.10.011.
Cuvellier JC. [Management of Chronic Daily Headache in Children and Adolescents]. Rev Neurol (Paris). 2009;165(6-7):521-31. PubMed PMID: 19041108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Management of chronic daily headache in children and adolescents]. A1 - Cuvellier,J-C, Y1 - 2008/11/28/ PY - 2008/06/11/received PY - 2008/08/06/revised PY - 2008/10/08/accepted PY - 2008/12/2/pubmed PY - 2009/9/5/medline PY - 2008/12/2/entrez SP - 521 EP - 31 JF - Revue neurologique JO - Rev. Neurol. (Paris) VL - 165 IS - 6-7 N2 - Chronic daily headache (CDH) affects 2 to 4% of adolescent females and 0,8 to 2% of adolescent males. CDH is diagnosed when headaches occur more than 4 hours a day, for greater than or equal to 15 headache days per month, over a period of 3 consecutive months, without an underlying pathology. It is manifested by severe intermittent headaches, that are migraine-like, as well as a chronic baseline headache. Silberstein and Lipton divided patients into four diagnostic categories: transformed migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. The second edition of the International Classification of Headache Disorders did not comprise any CDH category as such, but provided criteria for all four types of CDH: chronic migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. Evaluation of CDH needs to include a complete history and physical examination to identify any possibility of the headache representing secondary headaches. Children and adolescents with CDH frequently have sleep disturbance, pain at other sites, dizziness, medication-overuse headache and a psychiatric comorbidity (anxiety and mood disorders). CDH frequently results in school absence. CDH management plan is dictated by CDH subtype, the presence or absence of medication overuse, functional disability and presence of attacks of full-migraine superimposed. Reassuring, explaining, and educating the patient and family, starting prophylactic therapy and limiting aborting medications are the mainstay of treatment. It includes pharmacologic (acute and prophylactic therapy) and nonpharmacologic measures (biobehavioral management, biofeedback-assisted relaxation therapy, and psychologic or psychiatric intervention). Part of the teaching process must incorporate life-style changes, such as regulation of sleep and eating habits, regular exercise, avoidance of identified triggering factors and stress management. Emphasis must be placed on preventive measures rather than on analgesic or abortive strategies. Stressing the reintegration of the patient into school and family activities and assessing prognosis are other issues to address during the first visit. There are limited data evaluating the outcome of CDH in children and adolescents. SN - 0035-3787 UR - https://www.unboundmedicine.com/medline/citation/19041108/[Management_of_chronic_daily_headache_in_children_and_adolescents]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0035-3787(08)00584-5 DB - PRIME DP - Unbound Medicine ER -