EVOLUTION OF HEADACHE IN CHILDHOOD AND ADOLESCENCE - AN 8-YEAR FOLLOW-UP

Objective. Headache is a notable problem in clinical practice and a fr equent symptom in childhood and adolescence. The main aim of the prese nt study is to analyze the evolution of migraine and tension headache (TH) using an 8-year follow-up. Method. 100 subjects (F60, M40; mean a ge 17.9; SD 2.6; range 12-26), randomly selected among all patients fi rst seen in 1988 at the Headache Center, were directly contacted. We e mployed VIS criteria both in 1988 (the data were taken by the clinical charts) and 1996. We took into account changes in headache types and improvement, unchanging, worsening or remission of headache. This anal ysis was made with regard to gender differences and age at onset of he adache, too. The chi-squared test is employed. Findings. High tendency to remit (34%) or improve (45%) was recorded. A worsening situation w as seen in 6% and an unchanging situation in 15%. In 1988, we had 57% migraine without aura (MwoA), 7% migraine with aura, 28% episodic tens ion-type headache (ETTH), and 8% chronic TH (CTTH). In 1996, we saw 30 % MwoA, 2% MwA, 31% ETTH, and 3% CTH. Migraine shows a lower tendency to remit than TH (28.1% vs 44.4%). MwoA persists in the same form in 4 3.8% and becomes ETH in 26.3%. ETTH persists in the same form in 26.3% and changes in MwoA in 10.7%. Of headache-free subjects, we recorded a high tendency to remit (34%) and improve (95%); 13 were females (21. 7%) and 21 were males (52.5%). The course of headache is not related t o age at onset. Conclusion. Headache with juvenile onset changes its c haracteristics over time, with a high tendency to remit (mostly in mal es) or improve. The implications for pathophysiology and the role of h ormonal factors are called into question.