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This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 66, Number 2, January 24, 2006 All Versions of this Article: 01.wnl.0000183555.54305.fdv1 66/2/193    most recent Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, S.-J. Articles by Juang, K.-D. Search for Related Content PubMed PubMed Citation Articles by Wang, S.-J. Articles by Juang, K.-D. Related Collections All Headache Migraine Pediatric headache All epidemiology Prevalence studies

Chronic daily headache in adolescents

Prevalence, impact, and medication overuse

From the Neurological Institute (Drs. Wang and Fuh), Taipei Veterans General Hospital; Department of Neurology (Dr. Lu), Kaohsiung Medical University, Chung-Ho Memorial Hospital, Kaohsiung; Department of Psychiatry (Dr. Juang), Buddhist Tzu Chi General Hospital, Taipei, and Tzu Chi University School of Medicine, Hualian; and National Yang-Ming University School of Medicine (Drs. Wang and Fuh), Taipei, Taiwan.

Address correspondence and reprint requests to Dr. Shuu-Jiun Wang, The Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan; e-mail: sjwang{at}vghtpe.gov.tw

Objectives: To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample.

Methods: The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition.

Results: Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents.

Conclusions: Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

Editorial, see page 160

See also page 198

This article was previously published in electronic format as an Expedited E-pub on October 19, 2005, atwww.neurology.org.

Supported by grants from the National Science Council (NSC 89-2314-B-010-032) and Taipei Veterans General Hospital (VGH-295).

Disclosure: The authors report no conflicts of interest.

Received March 28, 2005. Accepted in final form August 15, 2005.

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