Clinical profile and disability of children presenting with chronic daily headache in a tertiary care hospital

Arulparithi Cuddalore Subramanian, T. Parvathi Devi, K. Ravikumar, V. Sivagamasundari


Background: The aim of the study is to analyses the clinical profile and disability of children presenting with chronic daily headache to the pediatric outpatient department.

Methods: Children and adolescents aged 5-15 years presenting to the paediatric outpatient department with chronic headache were included in the study after obtaining informed consent. Disability due to headache was assessed using the PedMIDAS scoring system. Headache severity was assessed using the visual analog scale for children above 6 years of age and Faces pain scale for children below 6 years.

Results: Thirty eight children and adolescents presenting with chronic headache were recruited into the study. Of these children and adolescents, 53% (20) were diagnosed with chronic migraine, 42% (16) children fulfilled the criteria for chronic Tension-type headache and 5% (2) had chronic migraine with aura. The mean Paediatric Migraine Disability Assessment score (PedMIDAS) used to assess the disability due chronic headache was 20.72.

Conclusions: Female gender and adolescent age groups are important risk factors for chronic daily headache. Most children and adolescents with CDH have mild disability as assessed using PedMIDAS scoring system.


Clinical profile, Chronic daily headache, Disability, Migraine, Tension-type headache

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Seshia S, Wang SJ, Ishaq Abu-Arafeh, Hershey AD, Guidetti, Winner, et al. Chronic daily headache in children and adolescents-a multi-faceted syndrome. Can J Neurol Sci. 2010;37:769-78.

Mishra, Sharma, Juneja M, Singh K. Recurrent Headache in Pediatric Outpatients at a Public Hospital in Delhi. Indian Pediatrics. 2013;50:775-8.

Gupta R, Bhatia, Dahiya, Sharma S, Sapra, Semalti K, et al. Recurrent Headache in Indian Adolescents. Indian J Pediatr. 2009;76.

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

Ozge A, Sasmaz T, Bugdayci R, Cakmak SE, Kurt AO, Kaleagasi SH, et al. The prevalence of chronic and episodic migraine in children and adolescents. Eur J Neurol. 2013;20:95-101.

Carlsson J, Larsson B, Mark A. Psychosocial functioning in school children with recurrent headaches. Headache. 1996;36:77-82.

Holden EW, Ladstein J, Trulsen M, Wall B. Chronic daily headache in children and adolescents. Headache. 1994 October;34(9):508-14.

Wang S, Fuh J, Lu S, Juang K. Chronic daily headache in adolescents: prevalence, impact and medication overuse. Neurology. 2006;66(2):193-7.

Hershey A, Powers S, Vockell, LeCates S, Kab. PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology. 2001 Dec;57(11):2034-9.

Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990 August;13(4):227-36.

Tsze DS, Baeyer CLv, Bulloch, Dayan PS. Validation of Self-Report Pain Scales in Children. Pediatrics. 2013 October;132(4):971-9.

Castillo, Munoz, Guitera, Pascual. Epidemiology of Chronic Daily Headache in the General Population. Headache. 1999;39:190-6.

Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. BMJ. 2001;322:11-45.

Stewart W, Lipton R, Celentano D, Reed M. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA. 1992;267:64-9.

Hameed Malik A, Shah PA, Yaseen Y. Prevalence of primary headache disorders in school-going children in Kashmir Valley (North-west India). Ann Indian Acad Neurol. 2012 August;Supplement1: 100-3.

Pacheva I, Ivanov I, Milanov I, Stefanov R. Distribution of chronic or recurrent headache in children and adolescents in two studies epidemiological study and clinical-based study. Pediatr Dimensions. 2016;1(6):130-4.

Shiang RL, Fuh JL, Wang S, Juang KD, Chen SP, Liao YC, et al. Incidence and risk factors of chronic daily headache in young adolescents: a school cohort study. Pediatrics. 2013 July;132.

Esposito, Gherpelli J, Esposito S. Chronic daily headaches in children and adolescents: a study of clinical characteristics. Cephalalgia. 2004;24:476-82.