Abstract
The objective of this study is to investigate the course of the diagnosis and characteristics of headache in 12- to 17-year-old adolescents during a follow-up period of 4 years. Headache prevalence and characteristics, and even the type of headache show important changes during adolescence. The course of adolescent headache might reveal important insight into the pathophysiology of headache. Subjects who received a single headache diagnosis were invited to participate in a follow-up study consisting of annual face-to-face evaluation of the subjects for 4 years. Subjects who had only one type of headache and who agreed to participate were included in the study. Each subject had four annual semi-structured interviews with a neurology resident. The International Classification of Headache Disorders second edition was used for case definitions. A total of 87 subjects completed the study: 64 girls (73.56%) and 23 boys (26.44%) (p = 0.016). The headache type included migraine in 50 adolescents (57.47%), tension type headache in 24 (27.59%), secondary headache in 5 (5.7%), and non-classifiable headache in 8 (9.2%). Headache has not remitted in any of the subjects. Headache diagnosis has changed in eighteen (20.69%) subjects at least once during the follow-up period. There was transformation of headache type in 4 of 50 with migraine (8%), 10 of 24 with tension-type headache (TTH) (41.7%), and 4 of 13 with other headaches (30.8%). In conclusion, transition of headache types from one type to another (more than once in some adolescents) and variability of diagnosis throughout the years strongly support the continuum theory of headaches.
Keywords: Adolescent, Headache, Migraine, Tension-type headache, Course, Transformation
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Conflict of interest
None.
References
- 1.Karlı N, Akış N, Zarifoğlu M, Akgöz S, et al. Headache prevalence in adolescents aged 12 to 17: a student based epidemiological study in Bursa. Headache. 2006;46(6):649–655. doi: 10.1111/j.1526-4610.2006.00362.x. [DOI] [PubMed] [Google Scholar]
- 2.Rother AD, Winner P (2001) Headache in children and Adolescents. In: Silberstein S et al (eds) Wolff’s Headache and other head pain. New York, Oxford University Press, pp 539–561
- 3.Özge A, Buğdaycı R, Şaşmaz Y, et al. The sensitivity and specificity of the case definition criteria in diagnosis of headache a school-based epidemiology study of 556 children in Mersin. Cephalalgia. 2003;23:138–145. doi: 10.1046/j.1468-2982.2003.00474.x. [DOI] [PubMed] [Google Scholar]
- 4.Buğdaycı R, Özge A, Şaşmaz T, et al. Prevalence and factors affecting headache in Turkish schoolchildren. Pediatr Int. 2005;47:316–322. doi: 10.1111/j.1442-200x.2005.02051.x. [DOI] [PubMed] [Google Scholar]
- 5.Laurall K, Larsson B, Eeg-Olofsson O. Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia. 2004;24:380–388. doi: 10.1111/j.1468-2982.2004.00681.x. [DOI] [PubMed] [Google Scholar]
- 6.Lewis DW. Toward the definition of childhood migraine. Curr Opin Pediatr. 2004;16:628–636. doi: 10.1097/01.mop.0000143763.17125.03. [DOI] [PubMed] [Google Scholar]
- 7.Mortimer MJ, Kay J, Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using Ad Hoc, Vahlquist and IHS criteria. Dev Med Child Neurol. 1992;34:1095–1101. doi: 10.1111/j.1469-8749.1992.tb11423.x. [DOI] [PubMed] [Google Scholar]
- 8.Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41:646–657. doi: 10.1046/j.1526-4610.2001.041007646.x. [DOI] [PubMed] [Google Scholar]
- 9.Karli N, Akgöz S, Zarifoğlu M, Akiş N, Erer S. Clinical characteristics of tension-type headache, migraine in adolescents: a student-based study. Headache. 2006;46(3):399–412. doi: 10.1111/j.1526-4610.2006.00372.x. [DOI] [PubMed] [Google Scholar]
- 10.International Headache Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 2003;24:24–36. [PubMed] [Google Scholar]
- 11.Silberstein SD. The role of sex hormones in headache. Neurology. 1992;42:37–42. [PubMed] [Google Scholar]
- 12.Marcus DA. Estrogen and tension type headache. Curr Pain Headache Rep. 2001;5:449–453. doi: 10.1007/s11916-001-0056-4. [DOI] [PubMed] [Google Scholar]
- 13.Sillanpaa M. Changes in the prevalence of migraine and other headaches during the first seven school years. Headache. 1983;23:15–19. doi: 10.1111/j.1526-4610.1983.hed2301015.x. [DOI] [PubMed] [Google Scholar]
- 14.Abu-Arefeh I, Russell G. Prevalence of headache and migraine in school children. BMJ. 1994;309:765–769. doi: 10.1136/bmj.309.6957.765. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Rhee H. Prevalence and predictors of headaches in US adolescents. Headache. 2000;40:528–538. doi: 10.1046/j.1526-4610.2000.00084.x. [DOI] [PubMed] [Google Scholar]
- 16.Nachit-Ouinekh F, Chrysostome V, Henry P, Nachit-Ouinekh F, Chrysostome V, Henry P, et al. Variability of reported headache symptoms and diagnosis of migraine at 12 months. Cephalalgia. 2005;25(2):117–123. doi: 10.1111/j.1468-2982.2004.00816.x. [DOI] [PubMed] [Google Scholar]
- 17.Guidetti V, Galli F. Evolution of headache in childhood and adolescence: an 8-year follow-up. Cephalalgia. 1998;18:449–454. doi: 10.1046/j.1468-2982.1998.1807449.x. [DOI] [PubMed] [Google Scholar]
- 18.Camarda R, Monastero R, Santangelo G, Raimondo D, Puma D, Pipia C, et al. Migraine headaches in adolescents: a five-year follow-up study. Headache. 2002;42:1000–1005. doi: 10.1046/j.1526-4610.2002.02229.x. [DOI] [PubMed] [Google Scholar]
- 19.Wang SJ, Fuh JL, Juang KD, Lu SR, Hsu LC, Chen WT, et al. Evolution of migraine diagnoses in adolescents: a 3-year annual survey. Cephalalgia. 2004;25:333–338. doi: 10.1111/j.1468-2982.2004.00859.x. [DOI] [PubMed] [Google Scholar]
- 20.Bille B. A 40-year follow-up of school children with migraine. Cephalalgia. 1997;17:488–491. doi: 10.1046/j.1468-2982.1997.1704488.x. [DOI] [PubMed] [Google Scholar]
- 21.Mazzotta G, Carboni F, Guidetti V, Sarchielli P, Felappa M, Gallai V, et al. Outcome of juvenile headache in outpatients attending 23 Italian headache clinics. Headache. 1999;39:737–746. doi: 10.1046/j.1526-4610.1999.3910737.x. [DOI] [PubMed] [Google Scholar]
- 22.Zebenholzer K, Wober C, Kienbacher C, Wöber-Bingöl C. Migrainous disorder and headache of the tension-type not fulfilling the criteria: a follow-up study in children and adolescents. Cephalalgia. 2000;20:611–616. doi: 10.1046/j.1468-2982.2000.00090.x. [DOI] [PubMed] [Google Scholar]
- 23.Monastero R, Camarda C, Pipia C, Camarda R. Prognosis of migraine headaches in adolescents: a 10-year follow-up study. Neurology. 2006;67:1353–1356. doi: 10.1212/01.wnl.0000240131.69632.4f. [DOI] [PubMed] [Google Scholar]
- 24.Virtanen R, Aromaa M, Rautava P, Metsahonkala L, Anttila P, Helenius H. Changing headache from preschool age to puberty. A controlled study. Cephalalgia. 2007;27:294–303. doi: 10.1111/j.1468-2982.2007.01277.x. [DOI] [PubMed] [Google Scholar]
- 25.Gassmann J, Morris L, Heinrich M, Kröner-Herwig B. One-year course of pediatric headache in children and adolescents aged 8–15 years. Cephalalgia. 2008;28:1154–1162. doi: 10.1111/j.1468-2982.2008.01657.x. [DOI] [PubMed] [Google Scholar]
- 26.Laurell K, Larsson B, Mattsson P, Eeg-Olofsson O. A 3-year follow-up of headache diagnoses and symptoms in Swedish schoolchildren. Cephalalgia. 2006;26:809–815. doi: 10.1111/j.1468-2982.2006.01113.x. [DOI] [PubMed] [Google Scholar]
- 27.Metsahonkala L, Sillanpaa M, Tuominen J. Outcome of early school-age migraine. Cephalalgia. 1997;17:662–665. doi: 10.1046/j.1468-2982.1997.1706662.x. [DOI] [PubMed] [Google Scholar]
- 28.Kienbacher C, Wöber C, Zesch HE, Hafferl-Gattermayer A, Posch M, Karwautz A, et al. Clinical features, classification and prognosis of migraine and tension-type headache in children and adolescents: a long-term follow-up study. Cephalalgia. 2006;26:820–830. doi: 10.1111/j.1468-2982.2006.01108.x. [DOI] [PubMed] [Google Scholar]
- 29.Dooley J, Bagnell A. The prognosis and treatment of headaches in children—a ten-year follow-up. Can J Neurol Sci. 1995;22:47–49. doi: 10.1017/s031716710004049x. [DOI] [PubMed] [Google Scholar]
- 30.Silberstein SD. Advances in understanding the pathophysiology of headache. Neurology. 1992;42:6–10. [PubMed] [Google Scholar]
- 31.Cady RK. The convergence hypothesis. Headache. 2007;47(Suppl 1):S44–S51. doi: 10.1111/j.1526-4610.2007.00676.x. [DOI] [PubMed] [Google Scholar]
