Headache in children in Dutch general practice

Aim: To describe the occurrence of headache in general practice, the diagno ses made in general practice, and the management. Method: Data from the Dut ch national survey of morbidity and interventions in general practice were used. The practice population (103 practices) comprised 63 753 children age d 0-14 years. Results: In 634 episodes, headache was a reason for encounter . The incidence of headache presented to the general practitioner was 40.2 per 1000 person years. More than half of the episodes were related to an in fectious disease, among which upper respiratory tract infections predominat ed. The incidence rate of the diagnosis idiopathic headache was 7.3 episode s per 1000 person years. The incidence increased with age and was higher in girls than in boys. In only 12% of cases of idiopathic headache were speci al investigations carried out, mostly blood examinations. Medication was pr escribed in 27% of all episodes of idiopathic headache. in the absence of a n infectious disease, many headache episodes were associated with psychosoc ial problems. Family problems and school problems were mentioned most often . Conclusion: Headache in children as reason for encounter is a common prob lem in general practice, often associated with an infectious disease. When confronted with a child with idiopathic headache, the general practitioner should be aware of a possible psychosocial component.