Prevalence and patterns of headache in school children in Karachi.

OBJECTIVE To determine the prevalence of headache, its different patterns and associated symptoms in school children. METHODS A population based, cross-sectional, questionnaire study, followed by interviews of selected cases and their opthalmoscopic examination was conducted in eight secondary schools from different parts of Karachi to cover all socioeconomic groups. A total of 1211 school children aged 12 to 20 years, were included. The main outcome measures studied were, prevalence of headache, associated symptoms and impact of positive family history. RESULTS The estimated prevalence rate of headache in school children was 85.5%. Of them 43.1% had mild, 46.6% had moderate and 8.8% had severe headache. Nearly half of them (49.6%) had a frequency of 3 or less episodes per month. Majority (58.7%) had no warning symptoms. The most common symptom prior to headache was subjective weakness (19.0%) followed by sensitivity to light (11.5%). The most common site was frontal headache (30.4%) and in 66.7% of the cases it was aching in character. Complaint of noise and light intolerance during headache was reported by 38.2%, 17.1% sought medical advice and only 0.4% needed hospitalization ever. Of those taking medicines (n =424 (41%) majority (82.3%) were self medicated. A positive family history was present in 52.5% children. All selected study subjects were found to have normal optic discs on ophthalmoscopic examination. CONCLUSION Headache is a major health problem in school children. It is inappropriately treated and there is strong impact of family history.