Pediatrics and Headaches
Annequin D, Tourniaire B, Massiou H, Migraine and headache in childhood and
adolescence. Pediatr Clin North Am, 2000 06, 47: 3, 617-31
Headache is one of the most common physical complaints of children and
adults. The authors have provided definitions of headache, a classification
system, diagnostic evaluations appropriate for children, and treatment
options for patients with acute and chronic headache. Also, this article has
emphasized the importance of diagnosing and treating migraine headache, a
painful malady that is extensively underestimated and misdiagnosed in the
pediatric population and one that can be treated acutely and when appropriate
prophylactically with great success. Lack of a specific biologic marker,
specific investigation, or brain imaging reduce these clinical entities too
often to a psychological illness. Nonpharmacologic treatments are pivotal to
manage chronic headaches. Migraine therapy, if administered early and through
the appropriate route, could provide important and rapid relief.
Deutsch J, Kastner U, Lackner R, Chronic Headache in Children and
Chiropractic Manipulation Conference Proceedings of the Chiropractic
Centennial 1995 Jul: 286-7
Conclusions: The study has a few serious limitations. The group of patients
was not homogenous. The questionnaires were only handed out once before and
once after treatment. Also there was no control group, but the chronic
headache-sufferers could serve as their own control. Still the results are in
line with the results of chiropractic manipulation for adult headaches. Under
chiropractic manipulative therapy of the cervical segmental dysfunctions the
children showed marked reduction of pain. This effect was best for reduction
of frequency, good for reduction of duration and least for reduction of
intensity of headaches. Randomised, placebo controlled and adequately
structured studies are needed to evaluate the efficacy of this form of
treatment.
Haney V, Chronic Pediatric Migraine-Type Headaches Treated By Long-Term
Inderol Prior To Chiropractic Care: A Case Report Proceedings of the
National Conference on Chiropractic 1993 Oct: 132-40
An 11-year-old pediatric female was referred to our practice by her because
of an eight year history of severe migraine-type headaches, and a four year
history of 20mg. intake of Inderol daily. This was prescribed for the
headaches, which were still incapacitating the child approximately two times
per week, despite medications. During examination it was eventually revealed
that the child had been a hit and run victim at 18 months, with her first
"known" headache occurring at about the age of three. Cervical and
thoraco-lumbo-pelvic x-rays revealed cervical hypolordosis, C1/C2
hyperextension subluxation and pelvic unleveling. Correction was accomplished
using diversified style adjustments following an applied kinesiological
work-up. The patient's initial complaint of severe headaches seems to have
been resolved, follow-up x-rays show that there has been a decrease in tho
racic and lumbar curvatures, she has slowly been weaned from Inderol, and is
off all pain medications as well.
Hewitt E, Chiropractic Care of a 13-Year-Old with Headache and Neck Pain: A
Case Report International Review of Chiropractic 1993 Oct: 90-8
Headaches are the most frequent cause of visits to primary care
practitioners. Standard medical care for headaches is prescription of pain
relieving medication. Is chiropractic care an effective treatment for
headaches in children? This report describes a 13-year-old female who has
suffered from severe headache and neck pain for five days. Following a series
of four chiropractic treatments over a two-week period, her headache and neck
pain resolved. A thorough search of the scholarly literature revealed no data
involving chiropractic treatment of headaches in children. This patient's
response suggests chiropractic care may be effective in this area and
requests further investigation.
Kandt RS; Levine RM, Headache and acute illness in children J Child Neurol,
1987 01; 2(1): 22-7.
Thirty-seven children with headaches who were seen in a walk-in clinic were
matched to 37 headache-free controls. Thirty percent of the headache group
and 11% of the headache-free control group had a body temperature above 38
degrees C (p less than 0.05). Nonrhythmic pain was more commonly associated
with fever than was rhythmic pain (p less than 0.05). Of 34 headache subjects
who completed questionnaires, those with more intense headaches reported a
greater number of headache-exacerbating factors (p less than 0.01). Bilateral
headaches were more painful than unilateral headaches, and in two thirds of
the subjects, the intensity of pain paralleled the course of the underlying
illness. A family history of migraine was more common in the headache group
as compared to the headache-free control group (p less than 0.05). Headaches
associated with acute illnesses may be a precursor to later migraine.
Language of Publication
Gascon GG, Chronic and recurrent headaches in children and adolescents.
Pediatr Clin North Am, 1984 10, 31: 5, 1027-51
Headache is a common chronic and recurrent symptom in children and
adolescents. The author discusses the prevalence of headache, its
differential diagnosis, interpretation of symptoms, methods of assessment,
and pharmacologic and nonpharmacologic treatment approaches.
Chiropractic and Headache Related Literature