Pediatric headache: A study in a Mexican headache clinic

INTRODUCTION: There are few studies on the epidemiology of headache in the pediatric population. As far as we know, in Mexico there is none on this matter. OBJECTIVE: To describe the epidemiology and clinical profile of headache in a pediatric population attending a Pediatric Neurology facility at a University Hospital. METHODS: Retrospective, transversal and observational study including all the patients attending the pediatric neurology service because of headache, from October 2010 to October 2011, ages between 1-16 years. All usual clinical variables, headache diagnosis and characteristics were studied and analyzed with descriptive statistics. RESULTS: A total of 115 patients were included: 50 male, and 65 females (43% and 57%, respectively). Most prevalent diagnosis were: migraine w/o aura (40.8%), secondary headache (33.9%), episodic tension-type (16.5%). All migraine patients were 52 (45.2%) 20/32 male/female). Important previous diseases were allergic 26.8%, cranial trauma 21.7%, present or past epilepsy 13.9%. Triggers were reported as negative in 73 (63.4%), non specified 21(18.2%), mental stress 6(5.2%), bad sleep habits 4(3.4%). Food triggers and noise were reported in 3 patients each. Two reported exercise and other 2 videogames as triggers. Food triggered headaches were tension type (1) and secondary headache (2). Premonitory symptoms were present in 7, were specifically denied in 87 (75.6%) and in 21 the data was missing. Attenuating factors were present in 82 (71.3%), denied in 15 (13%) and in 18 the data was missing. These factors were sleep 20%, and medications: ibuprofen, paracetamol, aspirin, diclofenac, ketorolac and naproxen. Aggravating factors were inadequately consigned in 71.3%. Comorbidities were present in 35 (30.4%): ADD 8, epilepsy 7, depression 7, familial conflict 17. CONCLUSION: Even with the bias that our population was sampled from a tertiary medical facility, our results suggest that in the pediatric Mexican population headache is an important medical problem. Most migraine patients had no triggers. There were no food triggered migraine. This is the first study of his kind in Mexico, so comparisons are difficult to make.