Skip to main content
PMC home page
The Journal of Headache and Pain logoLink to The Journal of Headache and Pain
. 2009 Sep 22;10(6):447–453. doi: 10.1007/s10194-009-0158-7

Treatment of primary headache in children: a multicenter hospital-based study in France

Jean-Christophe Cuvellier 1,6,✉, Anne Donnet 2, Évelyne Guégan-Massardier 3, Fatima Nachit-Ouinekh 4, Dominique Parain 5, Louis Vallée 1
PMCID: PMC2778781  PMID: 19771388

Abstract

The aim of this 6-month, prospective, multicenter study of 398 children and adolescents with primary headaches was to collect data on headache treatment in neuropediatric departments. Treatments were compared before and after consultation. Prior to consultation, the acute treatments that had been prescribed most frequently were paracetamol (82.2% of children) and non-steroidal anti-inflammatory drugs treatment (53.5%); 10.3% had received a prophylactic treatment. No differences in either acute or prophylactic treatment with respect to headache diagnosis were observed. After the neuropediatric consultation, paracetamol was replaced by a non-steroidal anti-inflammatory drug in about three-quarters of cases and by triptan in about one-quarter of cases. The number of children prescribed a prophylactic treatment nearly doubled, whereas there was a 5-fold and 23-fold increase in psychotherapy and relaxation training, respectively, between pre-referral and referral. We conclude that specific treatments were underused for primary headache.

Keywords: Headache, Migraine, Therapy, Children

Full Text

The Full Text of this article is available as a PDF (167.4 KB).

Acknowledgments

We thank Laboratoire GlaxoSmithKline, France, for its contribution to the implementation and data analysis for this study.

Conflict of interest

None.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Appendix

Céleste Study Group

Patrick Berquin, MD; Jacques Boulloche, MD; Jean-Paul Carrière, MD; Denys Chaigne, MD; Geneviève Demarquay, MD; Caroline Espil-Taris, MD; Sonia Finck, MD; Pierre Landrieu, MD; Marie-Odile Livet, MD; Catherine Louvet Giendaj, MD; Josette Mancini, MD; Pierre M’Bula, MD; Florence Meaulle, MD; Patricia Munoz-Lacoste, MD; Marie-José Penniello-Valette, MD; Sylviane Peudenier, MD; François Pouplard, MD; Christophe Rousselle, MD; Loïc Rambaud, MD; Pascal Sabouraud, MD.

Footnotes

On behalf of the Céleste Group.

The members of the Céleste Group are given in the Appendix.

References

  • 1.Latham J, Davies BD. The socioeconomic impact of chronic pain. Disabil Rehabil. 1994;16:39–44. doi: 10.3109/09638289409166435. [DOI] [PubMed] [Google Scholar]
  • 2.Frölund F, Frölund C. Pain in general practice: pain as a cause of patient–doctor contact. Scand J Prim Health Care. 1986;4:97–100. doi: 10.3109/02813438609014810. [DOI] [PubMed] [Google Scholar]
  • 3.Anttila P, Metsähonkala L, Sillanpää M. Long-term trends in the incidence of headache in Finnish schoolchildren. Pediatrics. 2006;117:e1197–e1201. doi: 10.1542/peds.2005-2274. [DOI] [PubMed] [Google Scholar]
  • 4.Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway, the Nord-Trøndelag Health Study (Head-HUNT-Youth): a large population-based epidemiological study. Cephalalgia. 2004;24:373–379. doi: 10.1111/j.1468-2982.2004.00680.x. [DOI] [PubMed] [Google Scholar]
  • 5.Andrasik F, Larsson B, Grazzi L. Biofeedback treatment of recurrent headaches in children and adolescents. In: Guidetti V, Russell G, Sillanpää M, Winner P, editors. Headache and migraine in childhood and adolescence. London: Martin Dunitz; 2002. pp. 317–322. [Google Scholar]
  • 6.Cuvellier JC, Donnet A, Guégan-Massardier E, Nachit-Ouinekh F, Parain D, Vallée L. Clinical features of primary headache in children: a multicentre hospital-based study in France. Cephalalgia. 2008;28:1145–1153. doi: 10.1111/j.1468-2982.2008.01656.x. [DOI] [PubMed] [Google Scholar]
  • 7.Headache Classification Committee The international classification of headache disorders, cranial neuralgia and facial pain, 2nd edition. Cephalalgia. 2004;24(Suppl 1):1–160. [Google Scholar]
  • 8.Lewis D, Ashwal S, Hershey A, Hirtz D, Yonker M, Silberstein S, American Academy of Neurology Quality Standards Subcommittee. Practice Committee of the Child Neurology Society Practice parameter: pharmacological treatment of migraine headache in children and adolescents, report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology. 2004;63:2215–2224. doi: 10.1212/01.wnl.0000147332.41993.90. [DOI] [PubMed] [Google Scholar]
  • 9.Hämäläinen ML, Hoppu K, Valkeila E, Santavuori P. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study. Neurology. 1997;48:103–107. doi: 10.1212/wnl.48.1.103. [DOI] [PubMed] [Google Scholar]
  • 10.Lewis DW. Children’s ibuprofen suspension for the acute treatment of pediatric migraine. Headache. 2002;42:780–786. doi: 10.1046/j.1526-4610.2002.02180.x. [DOI] [PubMed] [Google Scholar]
  • 11.Silver S, Gano D, Gerretsen P. Acute treatment of paediatric migraine: a meta-analysis of efficacy. J Paed Child Health. 2008;44:3–9. doi: 10.1111/j.1440-1754.2007.01206.x. [DOI] [PubMed] [Google Scholar]
  • 12.Anttila P. Tension-type headache in childhood and adolescence. Lancet Neurol. 2006;5:268–274. doi: 10.1016/S1474-4422(06)70376-3. [DOI] [PubMed] [Google Scholar]
  • 13.Lewis DW. Headaches in children and adolescents. Am Fam Physician. 2002;65:625–632. [PubMed] [Google Scholar]
  • 14.Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES) (2003) Recommandations pour la pratique clinique. Prise en charge diagnostique et thérapeutique de la migraine chez l’adulte et l’enfant Rev Neurol 159:126–135 [PubMed]
  • 15.Congdon PJ. Migraine in childhood: a study of 300 children. Dev Med Child Neurol. 1979;21:209–216. doi: 10.1111/j.1469-8749.1979.tb01603.x. [DOI] [Google Scholar]
  • 16.Hämäläinen ML, Hoppu K, Santavuori PR. Oral dihydroergotamine for therapy-resistant migraine attacks in children. Pediatr Neurol. 1997;16:114–117. doi: 10.1016/S0887-8994(96)00289-5. [DOI] [PubMed] [Google Scholar]
  • 17.Lewis DW, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache. 2004;44:230–237. doi: 10.1111/j.1526-4610.2004.04052.x. [DOI] [PubMed] [Google Scholar]
  • 18.Pothmann R. Medical prophylaxis in childhood migraine. In: Guidetti V, Russell G, Sillanpää M, Winner P, editors. Headache and migraine in childhood and adolescence. London: Martin Dunitz; 2002. pp. 251–256. [Google Scholar]
  • 19.Eccleston C, Morley S, Williams A, Yorke L, Mastroyannopoulou K. Systematic review of randomized controlled trials of psychological therapy for chronic pain in children and adolescents, with a subset meta-analysis of pain relief. Pain. 2002;99:157–165. doi: 10.1016/S0304-3959(02)00072-6. [DOI] [PubMed] [Google Scholar]
  • 20.Lewis DW, Scott D, Rendin V. Treatment of paediatric headache. Expert Opin Pharmacother. 2002;3:1433–1442. doi: 10.1517/14656566.3.10.1433. [DOI] [PubMed] [Google Scholar]
  • 21.Ferrari A, Pasciullo G, Savino G, Cicero AF, Ottani A, Bertolini A, Sternieri E. Headache treatment before and after the consultation of a specialized centre: a pharmacoepidemiology study. Cephalalgia. 2004;24:356–362. doi: 10.1111/j.1468-2982.2004.00678.x. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Headache and Pain are provided here courtesy of BMC

RESOURCES