Headaches are very common among children and rank third among illness-related causes for school absenteeism. Migraine headaches, particularly, are associated with significant disability and a reduced quality of life. Although there is considerable data on the features of migraine headache, there is little long-term data and the evolution of migraine from childhood to adulthood is poorly documented.

This current study, undertaken by Canadian researchers at Dalhousie University in Halifax, Nova Scotia, evaluates the long-term prognosis of childhood headaches after initial diagnosis in 1983 and again 20 years later. Seventy-seven of the original 95 headache patients first studied in 1983 were followed up in 2003.

Results
Sixty of the 77 patients responded (78%; 60 of the original 95). At the 20-year follow-up, 27% were headache-free, 33% had tension-type headaches, 17% had migraine, and 23% had migraine and tension-type headaches. More patients had more than one headache than at the time of initial diagnosis or initial follow-up, and the headache type varied over time. Of those who had headache at follow-up, 80% described their headaches as moderate or severe, although 66% said their headaches had improved.

During the month before follow-up, 70% of those with ongoing headaches were using non-prescription medications, and 14% were using prescription medications. However, 45% believed that non-drug methods were most effective. Medication use had increased during the 10 years since last follow-up, although no patients used triptans.

The researchers conclude that most patients continue to have headaches 20 years after diagnosis of pediatric headache, although the headache type often changes over time. As well, most patients report moderate or severe headaches and increasingly choose to treat their headaches with medication.

Source:
Brna P, et al. The prognosis of childhood headache: a 20-year follow-up. Arch Pediatr Adolesc Med 2005;159:1157-1160.