Rapid Transition from Intermittent to Continuous Headaches Found in Study of Children and Adolescents

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A study presented at the 2023 Scottsdale Headache Symposium found that children and adolescents transitioned from intermittent to continuous headache more quickly than adults, with 78% of participants reporting either sudden onset or rapid evolution to continuous headaches. The results of the study also revealed higher reported rates of headache-related disability for those rapidly evolving from intermittent to continuous headache compared with those with sudden onset headache. Additionally, headache-related disability was greater when continuous headache onset was associated with a trigger.

  • This was a single center, retrospective review of data collected prospectively from intake questionnaires of patients aged 6 to 17 years reporting with continuous headache.
  • A total of 389 of the 1415 questionnaires queried reported continuous headache and contained enough data for inclusion in the study analysis.
  • The median patient age was 14.7 years.
  • The aim of the study was to investigate the evolution to continuous headache, which included posttraumatic headache (PTH) and new daily persistent headache (NDPH), as well as to evaluate associations between circumstances of headache onset and headache-related disability.

Results of the study analysis revealed the following:

  • 44% of participants experienced sudden onset of continuous headache
  • 34% of participants experienced rapid evolution to continuous headache
  • 22% experienced gradual onset taking longer than 3 months

Nearly half of the participants had a diagnosis of migraine or probable migraine (48.4%), followed by

  • New daily persistent headache (19.2%)
  • New onset headache (15.1%)
  • Posttraumatic headache (12.1%)

Although more than half of participants (56.8%) reported no triggers, commonly reported triggers included

  • Multiple triggers (8.7%)
  • Stressful event (7.7%)
  • Concussion (7.7%)
  • Infection/Illness (2.3%)
  • Menses (2.1%)

The study authors suggest that future research should investigate factors that influence quicker headache evolution in children and factors that influence the perception of headache trigger and higher headache-related disability, as well as how headache evolution duration affects prognosis and recovery.

The study was conducted by authors from the Children’s Hospital of Philadelphia, Cincinnati Children’s Hospital, and the Perelman School of Medicine of the University of Pennsylvania.

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