CHILDHOOD HEADACHES - DISCRETE ENTITIES OR CONTINUUM

The aims of this study were to investigate the signs and symptoms of r ecurrent headaches in children and to identify if there are any discre te groups of children whose headaches corresponded to the World Federa tion of Neurology (1969) definition of migraine. One-hundred and fifty children recruited from the neurology clinics at Royal Manchester, Bo oth Hall, and Birmingham Children's Hospitals were interviewed to comp lete a standardized questionnaire. The data were examined using cluste r analysis followed by comparative analysis of the headache signs and symptoms in the different groups identified. No stable groups were ide ntified (i.e., no group was reliably identified by different methods o f cluster analysis) which corresponded to the World Federation of Neur ology definition of migraine. This would suggest that this definition is not appropriate for the sample investigated. Three groups of childr en evolved after cluster analysis. None of these groups was in agreeme nt with the International Headache Society classification of headaches . The groups were neither 'stable' clusters nor 'useful' in predicting prognosis. This outcome supports the continuum theory of headache syn dromes.