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Management of Chronic Daily Headache in Children and Adolescents

  • Therapy In Practice
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Abstract

Chronic daily headache (CDH) occurs in 1–2% of children and adolescents. It can evolve from either episodic tension-type headache or episodic migraine, or can appear with no previous headache history. As with other primary headache disorders, treatment is based on the level of disability. There are children and adolescents who cope well, but there are others who are markedly disabled by their chronic headaches. As in adults, children and adolescents with CDH are at risk for medication overuse.

CDH is a diagnosis of exclusion, based on a thorough history, normal physical examination, and negative neuroimaging findings. Along with the chronic headaches, children with this condition may have co-morbid sleep problems, autonomic dysfunction, anxiety, and/or depression. Principles of treatment include identifying migrainous components, stopping medication overuse, stressing normalcy, using rational pharmacotherapy, and addressing co-morbid conditions. Successful outcomes often involve identifying an appropriate headache preventative, reintegration into school, and family participation in resetting realistic expectations.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. Jack Gladstein is on the Speakers Bureau for GlaxoSmithKline, Pfizer and AstraZeneca.

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Authors and Affiliations

  1. Child and Adolescent Neurology, Mayo Clinic, 200 First St, SW, Rochester, Minnesota, 55905, USA

    Kenneth J. Mack

  2. School of Medicine, University of MarylanD, Maryland, USA

    Jack Gladstein

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  1. Kenneth J. Mack
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  2. Jack Gladstein
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Correspondence to Kenneth J. Mack.

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Mack, K.J., Gladstein, J. Management of Chronic Daily Headache in Children and Adolescents. Pediatr-Drugs 10, 23–29 (2008). https://doi.org/10.2165/00148581-200810010-00003

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