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This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 73, Number 6, August 11, 2009 Japanese Translation All Versions of this Article: WNL.0b013e3181ae2377v1 73/6/416    most recent Correspondence: Submit a response Correspondence: View responses 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 Google Scholar Articles by Wang, S.-J. Articles by Lu, S.-R. PubMed PubMed Citation Articles by Wang, S.-J. Articles by Lu, S.-R. Related Collections All Headache Adolescence Related Article

Chronic daily headache in adolescents

An 8-year follow-up study

From the Department of Neurology (S.-J.W., J.-L.F.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-J.W., J.-L.F.), Taipei Veterans General Hospital; and Department of Neurology (S.-R.L.), Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.

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

Objective: To assess the long-term outcome of a community-based adolescent cohort with chronic daily headache (CDH).

Methods: A field sample of 122 adolescents aged 12–14 years with CDH was established in 2000 (baseline) with short-term follow-up studies in 2001 and 2002. In 2008, the cohort was re-interviewed by physicians via telephone to determine the headache profile for the past year, including Migraine Disability Assessment (MIDAS), a headache disability questionnaire. Presence of CDH was defined as 15 headache days/month, average 4 hours/day for >3 months. Outcome measures included headache frequency, MIDAS score, and presence of CDH in 2008.

Results: A total of 103 subjects (26 male/77 female, mean age 21.6 ± 0.9 years) completed the study (response rate 84.4%). The average monthly headache frequency was 4.7 ± 6.0 (0–30) days. Twenty-eight (27.2%) subjects had moderate or severe headache disability (MIDAS 11). Twelve (12%) subjects met CDH criteria, with chronic migraine (n = 10, 83%) as the most common subtype. Two (2%) subjects overused medications. From 2000 to 2008, the frequencies of migraine diagnoses were fairly consistent in this cohort. Presence of migraine at baseline predicted poorer outcome of all 3 measures. Additionally, CDH onset <13 years old, duration 2 years, and medication overuse predicted either higher headache frequencies or presence of CDH in 2008.

Conclusions: This long-term follow-up study revealed a marked decline in the frequency of chronic daily headache (CDH). However, one fourth of patients still had significant headache disability. Migraine history was a major factor in evolution of CDH into young adulthood. Early onset and longer duration of CDH implied a protracted disease course.

Abbreviations: CDH = chronic daily headache; CI = confidence interval; CTTH = chronic tension-type headache; ETTH = episodic tension-type headache; HC = hemicrania continua; HR = hazard ratio; ICHD = International Classification of Headache Disorders; MIDAS = Migraine Disability Assessment; MINI-Kid = Mini-International Neuropsychiatric Interview-Kid; MOH = medication overuse headache; NDPH = new daily-persistent headache; TTH = tension-type headache.

Editorial, page 412

e-Pub ahead of print on July 15, 2009, at www.neurology.org.

Supported by grants from the Taipei-Veterans General Hospital and Kaohsiung Medical University Chung-Ho Memorial Hospital.

Disclosure: Author disclosures are provided at the end of the article.

Received November 24, 2008. Accepted in final form April 21, 2009.

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Chronic daily headache in adolescence: A continuing problem

Kenneth J. Mack and Andrew D. Hershey
Neurology 2009 73: 412-413. [Full Text] [PDF]

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				C. Kemp Teens with chronic headaches report improvements as they age AAP News, October 1, 2009; 30(10): 2 - 2. [Full Text] [PDF]

				K. J. Mack and A. D. Hershey Chronic daily headache in adolescence: A continuing problem Neurology, August 11, 2009; 73(6): 412 - 413. [Full Text] [PDF]

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