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Chronic Daily Headache in Children and Adolescents: A Multi-Faceted Syndrome

Published online by Cambridge University Press:  23 September 2016

Shashi S. Seshia ,
Shuu-Jiun Wang ,
Ishaq Abu-Arafeh ,
Andrew D. Hershey ,
Vincenzo Guidetti ,
Paul Winner  and
Çiçek Wöber-Bingöl
Shashi S. Seshia*
Affiliation:
Department of Pediatrics, Division of Pediatric Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Shuu-Jiun Wang
Affiliation:
Department of Neurology, National Yang-Ming University School of Medicine; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
Ishaq Abu-Arafeh
Affiliation:
Paediatric Neurology, Stirling Royal Infirmary, Stirling; Royal Hospital for Sick Children, Glasgow; University of Dundee, UK
Andrew D. Hershey
Affiliation:
Pediatrics and Neurology, University of Cincinnati, College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Vincenzo Guidetti
Affiliation:
Italian Headache Society, Department of Child and Adolescent Neurology, Psychiatry and Rehabilitation, University of Rome, “La Sapienza,”, Roma, Italy
Paul Winner
Affiliation:
Palm Beach Headache Center, Premiere Research Institute, Palm Beach Neurology, Nova Southeastern University, West Palm Beach, Florida, USA
Çiçek Wöber-Bingöl
Affiliation:
Department of Child and Adolescent Neuropsychiatry, University of Vienna, Wien-Vienna, Austria
*
Department of Pediatrics (Division of Pediatric Neurology), University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0W8Canada
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Abstract

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Chronic daily headache (CDH) is a multi-faceted, often complex pain syndrome in children and adolescents. Chronic daily headache may be primary or secondary. Chronic migraine and chronic tension-type are the most frequent subtypes. Chronic daily headache is co-morbid with adverse life events, anxiety and depressive disorders, possibly with other psychiatric disorders, other pain syndromes and sleep disorders; these conditions contribute to initiating and maintaining CDH. Hence, early management of episodic headache and treatment of associated conditions are crucial to prevention. There is evidence for the benefit of psychological therapies, principally relaxation and cognitive behavioral, and promising information on acupuncture for CDH. Data on drug treatment are based primarily on open label studies. The controversies surrounding CDH are discussed and proposals for improvement presented. The multifaceted nature of CDH makes it a good candidate for a multi-axial classification system. Such an approach should facilitate biopsychosocial management and enhance consistency in clinical research.

Résumé

Résumé

La céphalée quotidienne chronique (CQC) est un syndrome douloureux à multiples facettes qui est souvent complexe chez les enfants et les adolescents. La céphalée quotidienne chronique peut être primaire ou secondaire. La migraine chronique et la céphalée de tension chronique sont les sous-types les plus fréquents. La CQC est une comorbidité des incidents fâcheux de la vie, de l'anxiété et des troubles dépressifs, possiblement liée à d'autres troubles psychiatriques, syndromes douloureux et troubles du sommeil. Ces états contribuent à amorcer et à maintenir la CQC. Le traitement précoce de la céphalée épisodique et le traitement des comorbidités est donc crucial pour la prévention. Certaines données démontrent un bénéfice des psychothérapies, principalement de la relaxation et de la thérapie cognitivo-comportementale, et l'acuponcture pour le traitement de la CQC semble prometteuse. Les données sur le traitement médicamenteux sont basées principalement sur des études ouvertes. Nous discutons des controverses entourant la CQC et des moyens proposés pour améliorer son traitement. Le fait que la CQC possède de multiples facettes fait d'elle un bon candidat à un système de classification à plusieurs axes. Une telle approche devrait faciliter la prise en charge biopsychosociale et rehausser la cohérence dans le domaine de la recherche clinique.

Type
Review Articles
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 6 , November 2010 , pp. 769 - 778
Copyright
Copyright © The Canadian Journal of Neurological 2010

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