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Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were “alexithymia” combined with the “primary headache,” “migraine,” “tension type headache,” “children,” and “adolescents.” Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness. [ABSTRACT FROM AUTHOR]

Headaches are very common in children and adolescents. Headaches occur, on average, in 53% of children and adolescents. Most headaches are classified as migraines, tension headaches, or mixed headache syndrome. Headaches may be either acute or chronic and may be either progressive or non-progressive. Many headaches in children and adolescents are amenable to lifestyle changes and relaxation techniques. Medical management in conjunction with complimentary and alternative therapies often provides the best results for headache management. [ABSTRACT FROM AUTHOR]

The frequency and significance of headache in children and adolescent has been drawing more attention nowadays. Similarly, growing body of data is being collected on the quality of life of headache in children and adolescent to which increased attention is paid. Compared with other chronic disorders, headache in children has more negative effect on school performance, as well as emotional status. As for school children, it is reported that these children could not go to school on a regular basis, they do less performance and their careers are negatively affected on the long-term. Accompanying symptoms such as depression, somatization, anxiety also impairs the quality of life. Early identification and treatment of headache will not only improve a health condition, but also will provide advancement in academic and social area as well as psychological development for children with headache. [ABSTRACT FROM AUTHOR]

Objective: The current study provides the first measure of pain-related fear for pediatric headache patients.Methods: From a large pediatric headache clinic, a cross-sectional cohort of 206 children and adolescents completedmeasures of pain-related fear, anxiety sensitivity, catastrophizing, pain acceptance, functional disability, and schoolfunctioning.Results: The two-factor solution of the Fear of Pain Questionnaire (FOPQ) was confirmed from the originally derivedstructure with pediatric headache patients. Simultaneously regressing FOPQ subscales fear of pain and activity avoidanceon theorized construct validity measures demonstrated that fear of pain was more closely linked with anxiety sensitivityand pain catastrophizing while activity avoidance had a strong negative association with pain acceptance (activity engagementand pain willingness). Pain-related fear was not significantly associated with pain level. After controlling for demographicfactors and pain, fear of pain and activity avoidance accounted for an additional 26% of the variance in functionaldisability and school functioning outcomes, with activity avoidance accounting for much of this relationship.Conclusions: Although typically considered an influential construct among musculoskeletal patients, pain-related fear isalso an important factor influencing functioning among pediatric headache patients, with the dimension of activityavoidance particularly salient. [ABSTRACT FROM AUTHOR]

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Abstract: Background: Excessive gum-chewing is underreported as a headache precipitant in children and adolescents. We evaluated the influence of daily excessive gum-chewing in older children and teenagers with chronic headache, emphasizing the impact of habit discontinuation and its reintroduction. Methods: Patients with chronic headache and excessive gum-chewing were consecutively recruited and asked to fill questionnaire pertaining headache characteristics, potential triggers, family history of headaches, and gum-chewing habits. These individuals were classified into four groups depending on the number of daily hours of gum-chewing. All children discontinued chewing for 1 month, reintroduced the habit, and were reinterviewed after 2 to 4 weeks. Results: Thirty patients (25 girls) were recruited. Median age was 16 years. Most had migraine-like headaches. Following gum-chewing discontinuation, 26 reported significant improvement, including headache resolution in 19. All 20 patients reinstituting the habit reported symptom relapse within days. Duration of headache before discontinuation and the number of daily hours of chewing had no influence on the response to habit discontinuation. Conclusion: Excessive daily gum-chewing may be associated with chronic headache and should get more attention in the medical literature. Physician and patient awareness of this association could have a meaningful impact on the quality of life of children and adolescents with chronic headache who chew gum excessively. [Copyright &y& Elsevier]

Background: Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective: The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods: The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results: Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion: The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research. [ABSTRACT FROM AUTHOR]

The article presents abstracts on yoga research including hospital-based yoga for stroke survivors at Greater Baltimore Medical Center (GBMC), yoga for people with rheumatoid arthritis and yoga for children and adolescents with recurrent headache.

Background.— While adult headache patients' satisfaction with treatments has been widely investigated, less attention has been paid to children and adolescent headache patients' opinions and their parents' views. Objective.— The aim of our follow-up survey was to analyze the outcomes of the Headache Centre's intervention and the evolution of headache according to patients until the age of 16 and their parents. Methods.— We studied all outpatients suffering from episodic primary headache according to International Classification of Headache Disorders 2nd edition criteria, seen for the first time in 2005-2006 at the Headache Centre of the University Hospital of Modena (Italy), and at least one of their parents. The duration of the follow-up ranged from 1 to 3 years. For the purpose of the study, a specific questionnaire was created and administered by a telephone interview. Results.— We enrolled 84 patients (38 females, 45%; 46 males, 55%; mean age ± SD: 12.9 ± 2.9 years) with primary headache: migraine without aura 66%, episodic tension-type headache 23%, migraine with aura 11%. At the follow-up, 70% of the patients reported that headache had improved; frequency had decreased significantly more than severity ( P = .000, Fisher's exact test), both in those who had followed a prophylactic treatment and in those who had not. A high percentage of the children and parents could precisely indicate trigger factors for headache: especially excessive worrying and studying. The patients reporting an improvement attributed it to pharmacological prophylactic treatment, but also to other factors: first of all, better school results and more happiness than before. Seventy-seven percent of the parents thought that the Headache Centre's intervention had helped them to better understand and manage their children's headache. Conclusions.— Children's and adolescents' headache has in most cases a favorable prognosis; the Headache Centre's intervention is considered effective by most parents. We must increase and focus therapeutic efforts addressed to the few patients with worsening headaches in spite of treatment, since these children's/adolescents' headache also is at risk to progress in the adult age. [ABSTRACT FROM AUTHOR]

Psychologically based interventions such as relaxation training, biofeedback and cognitive-behavioural therapy are increasingly discussed as options for the treatment of migraine and tension-type headache in children and adolescents. In order to determine the state of evidence regarding the efficacy of these treatments, a meta-analysis of randomized controlled studies was conducted. In a comprehensive literature search including data from 1966 to 2004, 23 studies were found meeting the inclusion criteria. Due to the application of the random effects model, generalization of the results is possible. Specific statistical procedures were used to account for a possible publication bias. Significantly more patients improved to a clinically relevant extent (headache reduction ≥50%) in treatment conditions compared with waiting list conditions (high effect sizes). Long-term stability was also confirmed. The analysed treatments lead to improvement (up to 1 year) in headache status in children and adolescents with primary headache. However, more well-designed studies are needed to support and consolidate the conclusions of this meta-analysis and to compare the effects of psychological treatment with those of prophylactic medical interventions (in migraine), to examine potential differences between treatments, to identify moderators of efficacy and to determine effects of treatment on other health-related variables such as quality of life. [ABSTRACT FROM AUTHOR]

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor. [ABSTRACT FROM AUTHOR]

In this follow-up study in children and adolescents with recurrent headaches classified as migrainous disorder (IHS 1.7) and headache of the tension-type not fulfilling the criteria (IHS 2.3), 28.6% were headache-free and 71.4% still had headaches 2-5 years after the first examination. The majority remained in the same one-digit IHS diagnosis, whereas 20% changed from migraine to tension-type headache or vice versa. The number of IHS criteria fulfilled increased significantly from the first to the second examination. The reason for diagnosing IHS 1.7 and IHS 2.3 most often was a short headache duration or headache characteristics not meeting the criteria. By reducing the minimum headache duration to 1 h, 11 of 58 patients could be diagnosed as migraine without aura. There was a remarkable overlap in the diagnostic criteria for migraine without aura and tension-type headache. In IHS 1.7 and IHS 2.3 this overlap exceeded 80%, with a trend to decrease at the second examination. [ABSTRACT FROM AUTHOR]

To study the epidemiology of pediatric headache, we conducted a cross-sectional study of a randomized and proportional sample of 538 male and female students, 10 to 18 years old. They were in the 5th to 8th grade of the schools of Porto Alegre, RS Brazil. The headache disorders were classified on the basis of clinical interview as well as a physical and neurological examination using the operational diagnostic criteria of the International Headache Society (IHS The following headache prevalences were found: lifetime, 93.2%; last year, 82.9%; last week, 31.4%; last 24 h, 8.9%. Last week and last 24 h headache complaints were twice as prevalent in the female group. During the last year the prevalence of headache disorders was 72.8% for tension-type and 9.9% for migraine headache and was not associated with age distribution. Only the last year and last week prevalences of tension-type headache were significantly higher in the female group. The last year prevalence of headache disorder-proved to be positively associated with sex and age variables. The prevalence of headache disorders was found to be extremely high in this population group, requiring more attention on the part of investigators as a public health problem. [ABSTRACT FROM AUTHOR]

Purpose: Headaches are one of frequent complaints diagnosed in children and adolescents. Due to their recurring character, they influence the bio-psycho-social functioning of the children. The aim of the study was to learn about the factors influencing the quality of life of children with headaches. Material and methods: The research was conducted on 140 children with headaches, ages 8 to 18, treated at the Chair and Department of Developmental Neurology, Karol Marcinkowski University of Medical Sciences in Poznań. The research tool was the Pediatric Quality of Life Inventory -- PedsQL questionnaire. Results: In the studied group 85 (60.7%) children had tension headaches, 25 (17.8%) had migraine with aura and 30 (21.5%) had migraine without aura. Analyzing the particular domains of the quality of life from the PedsQL questionnaire, significant differences were noticed in the evaluation of the domain "physical functioning", depending on gender, age and the duration of pain, and in the domain "emotional functioning" depending on gender. The duration of pain additionally influenced the evaluation of their social functioning by the patients. Conclusions: The difference in the evaluation of the quality of life depended on the gender and the age of the children, the duration of headaches and the severity of pain. The indicated factors influenced different domains of the quality of life of the adolescents participating in the study. [ABSTRACT FROM AUTHOR]

Background: Headache is a common complaint in children and adolescents. Recently, an increased prevalence of headache in children and adolescents has been reported.Methods: We retrospectively reviewed the medical records of children and adolescents attending the Headache Clinic of Daejeon St. Mary's Hospital during the period from January 2005 through December 2016.Results: The study population consisted of 2466 children, aged between 3 and 18 years (mean age: 10.9). Our study showed an increase in the number of patients visiting the hospital with headaches during the past decade. Compared with 2005, the number of patients with headache increased three-fold in 2016. Interestingly, the proportion of boys, preschool children, and other primary headaches revealed a steady and statistically significant increase.Conclusion: Due to a steady increase in pediatric headaches, the earlier the problem is recognized and properly diagnosed and a treatment plan is established, the greater the likelihood of a better lifelong outcome. Studies are needed to estimate recent trend in prevalence and to identify the demographic and socioeconomic factors predicting the occurrence of headache. [ABSTRACT FROM AUTHOR]

Following the diagnostic indications of the Guidelines for the diagnosis and therapy of juvenile headache, we present the results of a prospective, multicentre study of headache patients aimed at evaluating the utility of neuroradiologic testing in the diagnosis of headache. A total of 6535 subjects up to age 18 were studied, and 1485 underwent neuroimaging testing based on the indications of the diagnostic Flow-Chart. Abnormal results were observed in 273 (18.5%) subjects. Incidental findings were observed in 138 (9.3%) subjects, not correlated with the headache pathology, whereas alterations that led to the diagnosis of secondary headache were observed in 135 (9.1%) subjects. In conclusion, our data support a greater incidence of positive neuroimaging examinations among patients who underwent testing based on suspicion of a secondary headache pathology when compared with the low percentages observed in study populations. [ABSTRACT FROM AUTHOR]