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Chronic Daily Headaches in Children
Hershey AD., Expert
Posted: September 2004  
Pharmacother 2003; 4:485-491

Chronic daily headache (CDH) or highly frequent headaches are being recognized as an increasing problem. In adults it is estimated that up to 4% of the population has CDH, however, this number appears to be lower in children. The actual prevalence of CDH in children, however, has not been determined. The simplest definition of CDH is >15 headache days per month. In the International Society (HIS) criteria, only chronic tension-type headaches and chronic cluster headaches are recognized as CDH. Criteria for CDH have been suggested for adults that mirror the HIS criteria. In children, the majority of CHD appear to be migraine-related. The next revision of the IHS criteria has been proposed to include chronic migraine as one of the CDH. Evaluation of CDH needs to include a complete history and physical examination to identify any possibility of the headache representing secondary headaches. Treatment and management involves a multitiered approach, which includes abortive therapy when the headache becomes more severe. With the precaution of avoiding overuse of analgesic medication, prophylactic therapy is used to help reduce the characteristics of the headache as well as the frequency and mild behavior therapy.