Primary headache disorders in children under 7 years of age

Abstract

Background and aim Research on headache disorders in young children is limited. This study aims to determine causes and clinical presentations of headache in young children attending a specialist clinic. Methods and results All children attending the headache clinic over 9-year period were included. Data were collected prospectively on demography and clinical presentations of headache at every attendance. The diagnosis of headache disorders was based on the International Classification of Headache Disorders-II (2004). Of the 921 children (491 male) who attended the clinic, 73 children (8%) were under 7 years of age at presentation; 34 children had migraine, 11 had tension-type headache (4 chronic), 4 had mixed types of headache and 16 children had unclassified headaches. Anorexia, nausea, vomiting, light intolerance and noise intolerance were common during migraine attacks and forehead was the most common site of maximal pain. Conclusions Migraine is the most common headache disorder in young children attending a specialist clinic. Headache presentation is often atypical and in 20% of young children headache disorders are unclassified. Chronic tension-type headache, often considered a disease of adolescents and adults, is shown to present in early age.