Distribution of chronic or recurrent headache in children and adolescents in two studies – epidemiological study and clinical-based study

An increasing incidence and significance of chronic or recurrent headache (CRH) in children and adolescents is observed. Aim: To compare the distribution of CRH types in epidemiological and clinical studies. Material and methods: The epidemiological study included 1029 pupils aged 7-17yrs attending three different types of schools in the Plovdiv region. Inclusion criterion was at least two episodes of headache in the last year. Exclusion criteria were headache only during infections or refusal to fillin questionnaire. The study was conducted in four steps: I– questionnaire; IIclinical interview, physical and neurological examination, IIIadditional investigations, IVclassification according to IHDC-II–2004. The clinical study included 203 newly diagnosed patients with CRH aged 0-17 years admitted to the Neuropediatric Ward or treated in an outpatient clinic during years 2002–2006. The clinical study started from step II. Results: Tension type headache (TTH) was the most frequent type of CRH in the epidemiological study – 42,5% of CRH, followed by migraine – 32%. Secondary headache comprised 2,7% of CRH. In the clinical setting, however, migraine was the commonest type of CRH – 46,8%, followed by TTH – 29,6%, and secondary headache 7,4%. There were no significant differences between inand outpatient case frequencies. Conclusions: TTH is the most prevalent headache type in children and adolescents. Migraine and secondary headache are more frequent in clinical settings than in epidemiological studies, probably because they induce search of medical help more frequently than TTH. Distribution of CRH types was similar in inand outpatient neuropediatric practices. Correspondence to: Iliyana Pacheva, Department of Pediatrics and Medical Genetics, Medical University – Plovdiv, 15A Vasil Aprilov str, 4000 Plovdiv, Bulgaria, Tel: +359 32 602251, Fax: +359 32 602547, E-mail: [email protected]