Headaches in childhood: note early warning signs

More than a third of all teenagers in Germany suffer from recurring headaches. This is proven by the first large epidemiological headache study of the German Migraine and Headache Society (DMKG), which was published in the current issue of the international journal "Cephalalgia". "Recurring childhood headaches are a risk factor for chronic adult headaches, " warn the authors of the study.

Headache in adolescents

Headaches are commonplace among teenagers, not just in adults. This is confirmed by a large-scale study by the German Migraine and Headache Society from West Pomerania, which has now been published in the journal "Cephalalgia". Half of West Pomeranian main real, private and secondary schools took part in the school survey conducted in the school year 2003/2004, and more than 3, 000 students completed the questionnaires.

Girls often have a headache

Seven out of ten teenagers said they had had a headache at least once in the last three months. For the girls it was 78.9 percent, for the boys 59.5 percent. Especially clear is the gender difference in recurring headaches. These gave 48 percent of 12- to 15-year-old girls and 26.5 percent of the same age boys. This affects girls twice as often as their male counterparts.

For girls, the incidence of recurring headaches increases significantly with age, from 42.8 percent at 12 to 53.6 percent at 15, but for boys, the increase is not statistically significant. "Why that is, we do not know exactly at the moment, " agree the authors of the study. The hormonal changes associated with the onset of puberty may play a role, especially in migraine.

Migraine affects girls even more

Even more marked than in tension-type headache is the gender difference in migraine. This plays a role in adolescents, especially if you adapt the strict criteria of the International Headache Society (IHS) to the changed circumstances in teenagers, that is, if you have a headache duration from 30 minutes instead of just four hours in the category "migraine" receives. In this definition, twelve out of one hundred 15-year-old girls suffer from migraine, but only four boys.

More education, more headache

Adolescents who attend secondary schools more often suffer from headaches than senior students. 17.6 percent of male high school graduates and 28 percent of high school students described headache over the previous three months. The girls were 38.8 and 51.1 percent, respectively.

"The connection between headache and social background, however, is controversial, " comment the authors of the study. The growing headaches are more likely to be the result of the extra workload of school lessons and homework.

writing a diary

To guide the therapeutic steps in the right direction, keeping a headache diary is an important tool. Scientific observations show that during the logged time the frequency of the complaints decreases.

"Although many young people find this annoying, only the diary really gives them an overview of the causes of their headaches, " Astrid Gendolla from the Department of Neurology at the University Hospital Essen. The sticking point, according to the neurologist, lies with young people in understanding the triggering mechanisms.

Relaxation is "uncool"

From her experience with adolescents Gendolla knows the medical dilemma: one would like to avoid an unnecessary medication, but "the young people do not want relaxation training." The headache specialist from Essen recommends an "educational approach" as an alternative: if adolescents understand what causes their headache, they can avoid triggering mechanisms such as alcohol consumption or sleep deprivation.

If occasional headache interferes with everyday life, it can be combated with paracetamol or ibuprofen, in the case of migraine with sumatriptan nasal spray.

Medication for chronification

If migraine headache occurs at least once a week, Gendolla recommends drug prophylaxis to prevent the symptoms from becoming chronic. "If a teenager has to interrupt his headache work three to four times a month, he should be given preventive treatment with the migraine flunarizine or the beta-blockers metoprolol and propronolol to prevent chronic pain, " advises the Essen neurologist.

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