Undifferentiated Headaches Common in Children, Adolescents

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An undifferentiated headache is one that differs measurably with respect to almost all headache features and has symptoms of both migraine and tension-type headache.
An undifferentiated headache is one that differs measurably with respect to almost all headache features and has symptoms of both migraine and tension-type headache.

Many children and adolescents suffer from headaches that do not conform to any current accepted diagnostic criteria, according to results published in The Journal of Headache and Pain.

These headaches, which the researchers call "undifferentiated headaches," have a significant impact on quality of life. The prevalence of these headaches highlights the need for longitudinal cohort studies to evaluate the prognosis of undifferentiated headaches.

The researchers introduced the diagnostic category of undifferentiated headache, which they defined in young people as a recurrent, mild-intensity headache lasting <1 hour.

In the meantime, clinicians should recognize undifferentiated headaches and the implications for epidemiologic studies, public-health policy, and routine clinical practice.

The researchers conducted a nationwide cross-sectional survey in 31 schools in 6 regions of Turkey (n=7088). A physician-investigator administered a questionnaire to entire classes of students age 6 to 17.

Of the surveyed students, 29.2% reported undifferentiated headache, 26.7% reported definite or probable migraine, and 12.9% reported definite or probable tension-type headache.

Participants with undifferentiated headache had a lower headache burden and the use of acute medication was lower compared with participants who reported migraines or tension-type headaches.

Headache the previous day was less common in participants with undifferentiated headache compared with participants with migraine (OR 0.32; 95% CI, 0.28-0.37) or tension-type headache (OR 0.64; 95% CI, 0.56-0.77).

Participants with undifferentiated headache had better quality of life (33.6±5.2) compared with participants with migraine (30.3±5.6; P <.001) and tension-type headache (32.4±5.3; P <.001). However, participants with undifferentiated headache had worse quality of life compared with participants without headache (35.7±4.7; P <.001).

Reference

Wöber C, Wöber-Bingöl C, Uluduz D, et al. Undifferentiated headache: broadening the approach to headache in children and adolescents, with supporting evidence from a nationwide school-based cross-sectional survey in Turkey.  J Headache Pain. 2018:19(1):18.

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