Anatomy of a Headache

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Long-Acting Opioids for
Refractory Chronic
Migraine

Study results for a group
of difficult-to-treat
migraineurs provide a
basis for determining
efficacy and guidelines
for the use of long-term
opioids in this
population.



Heatherís Chronic
Migraine: an Interactive
Case History

This column will take you,
step by step, through
the diagnosis of a complex
headache patient with
the pseudonym of "Heather."

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Migraine prevalence in school children: a population based study
Petur Ludvingsson, Dale C. Hesdorffer, Geetanjali D. Datta, et al
December 2010
From the VII International Conference on Headache in Children and Adolescents, Istanbul, Turkey; May 2008

Few studies have addressed the prevalence of migraine in children in a population based cohort. We report the prevalence of migraine in Icelandic schoolchildren between the ages of 7 and 15. A questionnaire regarding several episodic symptoms including details information on headache symptoms, personality traits, and socioeconomic status was distributed to all children in grades 1-10 in all 31 elementary schools in the city of Rekjavik, Iceland, parents or caretakers were asked to answer with the help of the child. Migraine and migraine with aura was defined, according to the International headache Society 1988 criteria, with modification regarding number of attacks (recurrent headache fulfilling migraine criteria vs. 5 lifetime attacks), duration of headache ( 2 hours vs. 4 hours) and aura (any visual, sensory or motor disturbance that preceded and was associated with the headache).

Of the 10,578 questionnaires returned (81.1%), 899 were excluded, leaving 9679 completed questionnaires...Using our modification, the period prevalence of migraine of 2 hours duration or greater in children aged 7-16 years was 8.2% (boys 7.2%, girls 9.1%). The prevalence of migraine increased from 2.0% at age 7, to 13.45 at age 15. An aura was present in 27% of all cases. The prevalence of migraine with aura across all age groups was 2.2% (boys 1.7%, girls 2.6%). The prevalence of migraine with aura increased with advancing age. The prevalence of migraine in this cohort is higher in each age group for both males and females than has been previously reported. This may indicate that the criteria we used to define migraine are more sensitive than those used by other studies.

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