HEADACHES IN YOUNG CHILDREN UNDER AGE 8

Objectives: To determine the frequency and types of headache (HA) seen in children under age 8. Do they have a higher frequency of “organic” headaches?

Methods: 680 patients with HA <18 years (2001–2003) were studied. An additional cohort of 339 patients <18 years (1994–1996) was re-analyzed. HA type used modified IHS criteria. 3 groups, ages 0–7, 8–12, 13–17. Data was compared to previous published studies.

Results: In both cohorts, children under 8 years comprise the smallest proportion of the patient pool (17%) when compared to children ages 8–12 (41%) and those 13–17 (42%). Males were more numerous in both studies. Migraine was the most common HA in this age group (59–77%). Chronic tension type headaches (TTH) were seen in 13–15% and a combination of migraine and TTH was seen 6.9–7.5%. Organic HA, most often trauma related in 8.8–8.9%. Tumors were rare. When the organic group were compared in patients 0–7, 8–12, 13–17, there were no statistically significant differences. Our data is similar to previously presented studies.

Conclusion: Our 2 combined studies suggest: HA are less frequent in this age group, migraine is the most common form of HA in this age group. All forms of HA become more frequent as children become older. TTH are statistically less frequent when compared to older children and adolescents. The combination of TTH and migraine HA are statistically less frequent when compared to the older groups. There was no increased frequency of “organic” HA in the younger group. Excessive school absences and overuse of OTC medication were nonexistent in this group. Both problems increased in the older groups. The recommendation made in a recent AAN parameter applies to this younger group. In the absence of neurological symptoms, or an abnormal neurological examination and/or a progressive course, most children can be managed clinically and organic disorders and routine imaging are not warranted.