Diagnosis and management of headache in children and adolescents: an overview

Background Headache is a common complaint in childhood with up to 75% of children reporting a notable headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache, occurring in up to 28% of older teenagers. Migraine can have a substantial effect on the life of the child, as well as their family, leading to lost school days and withdrawal from social interactions. The prevalence of non-migrainous headache is 10-25% in childhood and adolescence. Materials and methods The distinction of tension-type headache from migraine can be difficult. Although the International Classification of Headache Disorders criteria help, these criteria might be too restrictive to differentiate tension-type headache from migraine without aura in children. A headache diary is a useful method for the differentiation of headache types. The diagnosis of primary headache requires exclusion of secondary headache since many organic disorders can present as tension-type headache because disease-specific features are absent. Fever is the most common cause of benign paroxysmal headache. The basis of diagnosis is a systematic headache history, careful physical and neurological examination, including fundoscopy, and follow-up using a headache diary. If the results of neurological examination are normal in children with frequent headache neuroimaging is not routinely done. Results