Skip to main content

Advertisement

SpringerLink
Log in

Chronic Daily Headache in Children and Adolescents

  • Chronic Daily Headache (SJ Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Chronic daily headache (CDH) may be primary or secondary. Secondary causes can be suspected through “red flags” in the history and examination. With a prevalence of at least 1% and several associations, primary CDH is a common, often complex, chronic pain syndrome in children and adolescents. The intricate associations between stressors, psychiatric disorders (especially anxiety and depression), and CDH can be explained by “the limbically augmented pain syndrome” proposed by Rome and Rome. Disorders of sleep and other pain syndromes also may co-occur. For these reasons, a multiaxial classification is ideal. Many with primary CDH have features of both chronic migraine and chronic tension-type headache, contributing to confusion in subtyping. Primary CDH is often transformed from a primary episodic headache type, stressors being most responsible. Genetic factors also may facilitate chronification. Management should be biopsychosocial, family-centered, and often multidisciplinary, drugs being only one component. Treatment is still based on consensus, not evidence. Girls, migraineurs, and those with psychiatric comorbidity, medication overuse, and CDH onset before the age of 13 years and lasting for 2 years or longer, are at high risk for persistence; hence, such patients should be followed up into adult life. A classification for CDH should be included in the third edition of the International Classification of Headache Disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Mathew NT, Stubits E, Nigam MP. Transformation of episodic migraine into daily headache: analysis of factors. Headache. 1982;22(2):66–8.

    Article  PubMed  CAS  Google Scholar 

  2. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache classification committee of the international headache society. Cephalalgia. 1988;8 Suppl 7:1–96.

    Google Scholar 

  3. Silberstein SD, Lipton RB, Solomon S, Mathew NT. Classification of daily and near-daily headaches: proposed revisions to the IHS criteria. Headache. 1994;34(1):1–7. Seminal classification proposal for CDH.

    Article  Google Scholar 

  4. Welch KM, Goadsby PJ. Chronic daily headache: nosology and pathophysiology. Curr Opin Neurol. 2002;15(3):287–95.

    Article  PubMed  Google Scholar 

  5. Headache Classification Committee, Olesen J, Bousser MG, Diener HC, et al. New appendix criteria open for a broader concept of chronic migraine. Cephalalgia. 2006;26(6):742–6.

    Article  PubMed  CAS  Google Scholar 

  6. •• Seshia SS, Wang SJ, Abu-Arafeh I, et al. Chronic daily headache in children and adolescents: a multi-faceted syndrome. Can J Neurol Sci. 2010;37(6):769–78. This current, seven-center, multi-author, comprehensive review on CDH highlights the complex interlinks; it also addresses controversies surrounding the concept and classification and includes suggestions for “improvement”.

    PubMed  Google Scholar 

  7. • Manzoni GC, Torelli P. Chronic migraine and chronic tension-type headache: are they the same or different? Neurol Sci. 2009;30 Suppl 1:S81-4. This is an excellent discussion on the controversies surrounding chronic migraine.

    Article  PubMed  Google Scholar 

  8. •• Manzoni GC, Torelli P. Proposal for a new classification of chronic headache. Neurol Sci. 2010;31 Suppl 1:S9-13. This is an excellent exposition of the controversies surrounding chronic headache, with suggestions for improvement.

    Article  PubMed  Google Scholar 

  9. Nappi G, Granella F, Sandrini G, Manzoni GC. Chronic daily headache. How should it be included in the IHS classification? Headache. 1999;39(3):197–203.

    Article  PubMed  CAS  Google Scholar 

  10. Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9–160.

    Google Scholar 

  11. Seshia SS, Wober-Bingol C, Guidetti V. The classification of chronic headache: room for further improvement? 2010;30(10):1268–70.

  12. Wang SJ, Fuh JL, Lu SR, Juang KD. Chronic daily headache in adolescents: prevalence, impact, and medication overuse. Neurology. 2006;66(2):193–7.

    Article  PubMed  Google Scholar 

  13. •• Arruda MA, Guidetti V, Galli F, Albuquerque RC, Bigal ME. Frequent headaches in the preadolescent pediatric population: a population-based study. Neurology. 2010;74(11):903–08. This is a recent population-based study from Brazil.

    Article  PubMed  CAS  Google Scholar 

  14. • Lipton RB, Manack A, Ricci JA, et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS). Headache. 2011;51(5):693–706. This is a recent large population-based study from the United States.

    Article  PubMed  Google Scholar 

  15. Ozge A, Bugdayci R, Sasmaz T, et al. The sensitivity and specificity of the case definition criteria in diagnosis of headache: a school-based epidemiological study of 5562 children in Mersin. Cephalalgia. 2003;23(2):138–45.

    Article  PubMed  CAS  Google Scholar 

  16. Laurell K, Larsson B, Eeg-Olofsson O. Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia. 2004;24(5):380–8.

    Article  PubMed  CAS  Google Scholar 

  17. Raieli V, Eliseo M, Pandolfi E, et al. Recurrent and chronic headaches in children below 6 years of age. J Headache Pain. 2005;6(3):135–42. Only clinic based study to date addressing chronic headache in younger children.

    Article  PubMed  Google Scholar 

  18. Cevoli S, Sancisi E, Grimaldi D, et al. Family history for chronic headache and drug overuse as a risk factor for headache chronification. Headache. 2009;49(3):412–8.

    Article  PubMed  Google Scholar 

  19. Montagna P, Cevoli S, Marzocchi N, et al. The genetics of chronic headaches. Neurol Sci. 2003;24 Suppl 2:S51–6.

    PubMed  Google Scholar 

  20. Seshia SS, Phillips DF, von Baeyer CL. Childhood chronic daily headache: a biopsychosocial perspective. Dev Med Child Neurol. 2008;50(7):541–5.

    Article  PubMed  CAS  Google Scholar 

  21. Arruda MA, Guidetti V, Galli F, et al. Frequency of headaches in children is influenced by headache status in the mother. Headache. 2010;50(6):973–80.

    Article  PubMed  Google Scholar 

  22. Manack A, Turkel C, Silberstein S. The evolution of chronic migraine: classification and nomenclature. Headache. 2009;49(8):1206–13.

    Article  PubMed  Google Scholar 

  23. Solomon S. New appendix criteria open for a broader concept of chronic migraine. Cephalalgia. 2007;27(5):469. author reply 469–470.

    Article  PubMed  Google Scholar 

  24. Sun-Edelstein C, Bigal ME, Rapoport AM. Chronic migraine and medication overuse headache: clarifying the current international headache society classification criteria. Cephalalgia. 2009;29(4):445–52.

    Article  PubMed  CAS  Google Scholar 

  25. Mathew NT, Reuveni U, Perez F. Transformed or evolutive migraine. Headache. 1987;27(2):102–6.

    Article  PubMed  CAS  Google Scholar 

  26. Kung E, Tepper SJ, Rapoport AM, et al. New daily persistent headache in the paediatric population. Cephalalgia. 2009;29(1):17–22.

    Article  PubMed  CAS  Google Scholar 

  27. Mack KJ. What incites new daily persistent headache in children? Pediatr Neurol. 2004;31(2):122–5.

    Article  PubMed  Google Scholar 

  28. • Radat F, Creac’h C, Guegan-Massardier E, et al. Behavioral dependence in patients with medication overuse headache: a cross-sectional study in consulting patients using the DSM-IV criteria. Headache. 2008;48(7):1026–36. This is an important paper on medication overuse and dependence.

    Article  PubMed  Google Scholar 

  29. Fuh JL, Wang SJ, Lu SR, Juang KD. Does medication overuse headache represent a behavior of dependence? Pain. 2005;119(1–3):49–55.

    Article  PubMed  Google Scholar 

  30. •• Hershey AD, Burdine D, Kabbouche MA, Power SW. Genomic expression patterns in medication overuse headaches. Cephalalgia. 2011;31(2):161–71. This is an important study supporting a genetic basis for medication overuse.

    Article  PubMed  Google Scholar 

  31. De Felice M, Ossipov MH, Porreca F. Update on medication-overuse headache. Curr Pain Headache Rep. 2011;15(1):79–83.

    Article  PubMed  Google Scholar 

  32. Seshia SS. Chronic daily headache in children and adolescents. Can J Neurol Sci. 2004;31(3):319–23.

    PubMed  Google Scholar 

  33. Hershey AD, Powers SW, Bentti AL, et al. Characterization of chronic daily headaches in children in a multidisciplinary headache center. Neurology. 2001;56(8):1032–7.

    PubMed  CAS  Google Scholar 

  34. Bigal ME, Sheftell FD, Tepper SJ, et al. Migraine days decline with duration of illness in adolescents with transformed migraine. Cephalalgia. 2005;25(7):482–7.

    Article  PubMed  CAS  Google Scholar 

  35. Moore AJ, Shevell M. Chronic daily headaches in pediatric neurology practice. J Child Neurol. 2004;19(12):925–9.

    PubMed  Google Scholar 

  36. • Ji T, Mack KJ. Unilateral chronic daily headache in children. Headache. 2009;49(7):1062–65. This article provides good clinical information on unilateral CDH.

    Article  PubMed  Google Scholar 

  37. • Seshia SS, Abu-Arafeh I, Hershey AD. Tension-type headache in children: the Cinderella of headache disorders! Can J Neurol Sci. 2009;36(6):687–95. This is a recent tricenter comprehensive review on tension-type headache (including chronic) in children and adolescents.

    PubMed  Google Scholar 

  38. Senbil N, Gurer YK, Uner C, Barut Y. Sinusitis in children and adolescents with chronic or recurrent headache: a case-control study. J Headache Pain. 2008;9(1):33–6.

    Article  PubMed  Google Scholar 

  39. Wang SJ, Silberstein SD, Patterson S, Young WB. Idiopathic intracranial hypertension without papilledema: a case-control study in a headache center. Neurology. 1998;51(1):245–9.

    PubMed  CAS  Google Scholar 

  40. Beri S, Gosalakkal JA, Hussain N, et al. Idiopathic intracranial hypertension without papilledema. Pediatr Neurol. 2010;42(1):56–8.

    Article  PubMed  Google Scholar 

  41. Seshia SS. Specificity of IHS criteria in childhood headache. Headache. 1996;36(5):295–9.

    Article  PubMed  CAS  Google Scholar 

  42. Marcon RA, Labbe EE. Assessment and treatment of children’s headaches from a developmental perspective. Headache. 1990;30(9):586–92.

    Article  PubMed  CAS  Google Scholar 

  43. Andrasik F, Powers SW, McGrath PJ. Methodological considerations in research with special populations: children and adolescents. Headache. 2005;45(5):520–5.

    Article  PubMed  Google Scholar 

  44. De Luca CR, Wood SJ, Anderson V, et al. Normative data from the CANTAB.I: development of executive function over the lifespan. J Clin Exp Neuropsychol. 2003;25(2):242–54.

    Article  PubMed  Google Scholar 

  45. Sourander A, Brunstein Klomek A, Ikonen M, et al. Psychosocial risk factors associated with cyberbullying among adolescents: a population-based study. Arch Gen Psychiatry. 2010;67(7):720–8.

    Article  PubMed  Google Scholar 

  46. Rome Jr HP, Rome JD. Limbically augmented pain syndrome (LAPS): kindling, corticolimbic sensitization, and the convergence of affective and sensory symptoms in chronic pain disorders. Pain Med. 2000;1(1):7–23.

    Article  PubMed  Google Scholar 

  47. Wang SJ, Juang KD, Fuh JL, Lu SR. Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache. Neurology. 2007;68(18):1468–73.

    Article  PubMed  Google Scholar 

  48. da Silva Jr A, Costa EC, Gomes JB, et al. Chronic headache and comorbidities: a two-phase, population-based, cross-sectional study. Headache. 2010;50(8):1306–12.

    Article  PubMed  Google Scholar 

  49. Pakalnis A, Butz C, Splaingard D, et al. Emotional problems and prevalence of medication overuse in pediatric chronic daily headache. J Child Neurol. 2007;22(12):1356–9.

    Article  PubMed  Google Scholar 

  50. Fujita M, Fujiwara J, Maki T, et al. Pediatric chronic daily headache associated with school phobia. Pediatr Int. 2009;51(5):621–5.

    Article  PubMed  Google Scholar 

  51. Knook LM, Konijnenberg AY, van der Hoeven J, et al. Psychiatric disorders in children and adolescents presenting with unexplained chronic pain: what is the prevalence and clinical relevancy? Eur Child Adolesc Psychiatry. 2011;20(1):39–48.

    Article  PubMed  Google Scholar 

  52. Galli F, Canzano L, Scalisi TG, Guidetti V. Psychiatric disorders and headache familial recurrence: a study on 200 children and their parents. J Headache Pain. 2009;10(3):187–97.

    Article  PubMed  Google Scholar 

  53. Pinhas-Hamiel O, Frumin K, Gabis L, et al. Headaches in overweight children and adolescents referred to a tertiary-care center in Israel. Obesity (Silver Spring). 2008;16(3):659–63.

    Article  Google Scholar 

  54. Juang KD, Wang SJ, Fuh JL, et al. Association between adolescent chronic daily headache and childhood adversity: a community-based study. Cephalalgia. 2004;24(1):54–9.

    Article  PubMed  Google Scholar 

  55. Peterlin BL, Ward T, Lidicker J, Levin M. A retrospective, comparative study on the frequency of abuse in migraine and chronic daily headache. Headache. 2007;47(3):397–401.

    PubMed  Google Scholar 

  56. Robberstad L, Dyb G, Hagen K, et al. An unfavorable lifestyle and recurrent headaches among adolescents: the HUNT study. Neurology. 2010;75(8):712–7.

    Article  PubMed  CAS  Google Scholar 

  57. Tassorelli C, Sances G, Allena M, et al. The usefulness and applicability of a basic headache diary before first consultation: results of a pilot study conducted in two centres. Cephalalgia. 2008;28(10):1023–30.

    Article  PubMed  CAS  Google Scholar 

  58. Lewis DW, Dorbad D. The utility of neuroimaging in the evaluation of children with migraine or chronic daily headache who have normal neurological examinations. Headache. 2000;40(8):629–32.

    Article  PubMed  CAS  Google Scholar 

  59. Torbey MT, Geocadin RG, Razumovsky AY, et al. Utility of CSF pressure monitoring to identify idiopathic intracranial hypertension without papilledema in patients with chronic daily headache. Cephalalgia. 2004;24(6):495–502.

    Article  PubMed  CAS  Google Scholar 

  60. •• Mack KJ. Management of chronic daily headache in children. Expert Rev Neurother. 2010;10(9):1479–86. This recent paper on management provides several excellent clinical pearls.

    Article  PubMed  Google Scholar 

  61. Cuvellier JC. Management of chronic daily headache in children and adolescents. Rev Neurol (Paris). 2009;165(6–7):521–31.

    Article  Google Scholar 

  62. Gladstein J, Rothner AD. Chronic daily headache in children and adolescents. Semin Pediatr Neurol. 2010;17(2):88–92.

    Article  PubMed  Google Scholar 

  63. Wang SJ, Fuh JL, Lu SR, Juang KD. Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study. Neurology. 2007;68(8):591–6.

    Article  PubMed  Google Scholar 

  64. Gottschling S, Meyer S, Gribova I, et al. Laser acupuncture in children with headache: a double-blind, randomized, bicenter, placebo-controlled trial. Pain. 2008;137(2):405–12.

    Article  PubMed  Google Scholar 

  65. Witt CM, Ludtke R, Willich SN. Homeopathic treatment of chronic headache (ICD-9: 784.0)--a prospective observational study with 2-year follow-up. Forsch Komplementmed. 2009;16(4):227–35.

    Article  PubMed  Google Scholar 

  66. Eccleston C, Palermo TM, Williams AC, et al. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev. 2009;2(2):CD003968.

    PubMed  Google Scholar 

  67. • Sieberg SB, Huguet.A, von Baeyer CL, Seshia SS. Psychological interventions for headache in children and adolescents. Can J Neurol Sci. 2011. In Press. This current paper reviews the various psychological interventions for childhood headache.

  68. Lewis DW, Winner P, Wasiewski W. The placebo responder rate in children and adolescents. Headache. 2005;45(3):232–9.

    Article  PubMed  Google Scholar 

  69. Charles JA, Jotkowitz S. Observations of the “carry-over effect” following successful termination of chronic migraine in the adolescent with short-term dihydroergotamine, dexamethasone and hydroxyzine: a pilot study. J Headache Pain. 2005;6(1):51–4.

    Article  PubMed  CAS  Google Scholar 

  70. Ashina S, Bendtsen L, Ashina M. Pathophysiology of tension-type headache. Curr Pain Headache Rep. 2005;9(6):415–22.

    Article  PubMed  Google Scholar 

  71. Colombo B, Dalla Libera D, Annovazzi PO, Comi G. Headache therapy with neuronal stabilising drugs. Neurol Sci. 2008;29 Suppl 1:S131–136.

    Article  PubMed  Google Scholar 

  72. Borzy JC, Koch TK, Schimschock JR. Effectiveness of topiramate in the treatment of pediatric chronic daily headache. Pediatr Neurol. 2005;33(5):314–6.

    Article  PubMed  Google Scholar 

  73. Gherpelli JL, Esposito SB. A prospective randomized double blind placebo controlled crossover study of fluoxetine efficacy in the prophylaxis of chronic daily headache in children and adolescents. Arq Neuropsiquiatr. 2005;63(3A):559–63.

    Article  PubMed  Google Scholar 

  74. Chan VW, McCabe EJ, MacGregor DL. Botox treatment for migraine and chronic daily headache in adolescents. J Neurosci Nurs. 2009;41(5):235–43.

    Article  PubMed  Google Scholar 

  75. Ahmed K, Oas KH, Mack KJ, Garza I. Experience with botulinum toxin type A in medically intractable pediatric chronic daily headache. Pediatr Neurol. 2010;43(5):316–9.

    Article  PubMed  Google Scholar 

  76. Marmura MJ, Passero Jr FC, Young WB. Mexiletine for refractory chronic daily headache: a report of nine cases. Headache. 2008;48(10):1506–10.

    Article  PubMed  Google Scholar 

  77. Mack KJ, Gladstein J. Management of chronic daily headache in children and adolescents. Paediatr Drugs. 2008;10(1):23–9.

    Article  PubMed  Google Scholar 

  78. Prakash S, Husain M, Sureka DS, et al. Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review. J Neurol Sci. 2009;277(1–2):187–90.

    Article  PubMed  CAS  Google Scholar 

  79. Linder SL. Treatment of childhood headache with dihydroergotamine mesylate. Headache. 1994;34(10):578–80.

    Article  PubMed  CAS  Google Scholar 

  80. •• Wang SJ, Fuh JL, Lu SR. Chronic daily headache in adolescents: an 8-year follow-up study. Neurology. 2009;73(6):416–22. This is the best community-based long-term follow-up study to date (from the Taiwanese group).

    Article  PubMed  Google Scholar 

  81. Solomon S, Lipton RB, Newman LC. Clinical features of chronic daily headache. Headache. 1992;32(7):325–9.

    Article  PubMed  CAS  Google Scholar 

  82. Srikiatkhachorn A, Phanthumchinda K. Prevalence and clinical features of chronic daily headache in a headache clinic. Headache. 1997;37(5):277–80.

    Article  PubMed  CAS  Google Scholar 

  83. Charles JA, Peterlin BL, Rapoport AM, et al. Chronic daily headache in adolescents: an 8-year follow-up study. Neurology. 2010;74(9):780. author reply 780–781.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Dr. Seshia thanks the Department of Pediatrics and the Faculty of Medicine, University of Saskatchewan for continuing support, and Drs. Chitra and Narayan Prasad, Department of Pediatrics, University of Western Ontario (London, Ontario, Canada) for helpful discussion.

Disclosures

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Division of Pediatric Neurology, University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8, Canada

    Shashi S. Seshia

Authors
  1. Shashi S. Seshia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shashi S. Seshia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Seshia, S.S. Chronic Daily Headache in Children and Adolescents. Curr Pain Headache Rep 16, 60–72 (2012). https://doi.org/10.1007/s11916-011-0228-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-011-0228-9

Keywords

Search

Navigation