Primary headaches, attention deficit disorder and learning disabilities in children and adolescents

Jacob Genizi, Shiri Gordon, Nogah C Kerem, Isaac Srugo, Eli Shahar, Sarit Ravid, Jacob Genizi, Shiri Gordon, Nogah C Kerem, Isaac Srugo, Eli Shahar, Sarit Ravid

Abstract

Background: Primary headaches and Learning difficulties are both common in the pediatric population. The goal of our study was to assess the prevalence of learning disabilities and attention deficit disorder in children and adolescents with migraine and tension type headaches.

Methods: Retrospective review of medical records of children and adolescents who presented with headache to the outpatient pediatric neurology clinics of Bnai-Zion Medical Center and Meyer Children's Hospital, Haifa, during the years 2009-2010. Demographics, Headache type, attention deficit disorder (ADHD), learning disabilities and academic achievements were assessed.

Results: 243 patients met the inclusion criteria and were assessed: 135 (55.6%) females and 108 (44.4%) males. 44% were diagnosed with migraine (35.8% of the males, 64.2% of the females, p = 0.04), 47.7% were diagnosed with tension type headache (50.4% of the males, 49.6% of the females). Among patients presenting with headache for the first time, 24% were formerly diagnosed with learning disabilities and 28% were diagnosed with attention deficit disorder (ADHD). ADHD was more prevalent among patients with tension type headache when compared with patients with migraine (36.5% vs. 19.8%, p = 0.006). Poor to average school academic performance was more prevalent among children with tension type headache, whereas good to excellent academic performance was more prevalent among those with migraine.

Conclusions: Learning disabilities and ADHD are more common in children and adolescents who are referred for neurological assessment due to primary headaches than is described in the general pediatric population. There is an association between headache diagnosis and school achievements.

References

    1. Stovner L, Hagen K, Jensen R. et al.The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;14(3):193–210. doi: 10.1111/j.1468-2982.2007.01288.x.
    1. Genizi J, Srugo I, Kerem CN. The cross-ethnic variations in the prevalence of headache and other somatic complaints among adolescents in Northern Israel. J Headache Pain. 2013;14:21. doi: 10.1186/1129-2377-14-21.
    1. Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trondelag Health Study (Head-HUNT-Youth), a large population based epidemiological study. Cephalalgia. 2004;14(5):373–379. doi: 10.1111/j.1468-2982.2004.00680.x.
    1. Ando N, Fujimoto S, Ishikawa T. et al.Prevalence and features of migraine in Japanese junior high school students aged 12–15 yr. Brain Dev. 2007;14(8):482–485. doi: 10.1016/j.braindev.2007.01.003.
    1. Akyol A, Kiylioglu N, Aydin I. et al.Epidemiology and clinical characteristics of migraine among school children in the Menderes region. Cephalalgia. 2007;14(7):781–787. doi: 10.1111/j.1468-2982.2007.01343.x.
    1. Bille B. A 40-year follow-up of school children with migraine. Cephalalgia. 1997;14(4):488–491. doi: 10.1046/j.1468-2982.1997.1704488.x.
    1. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;14(6):942–948. doi: 10.1176/appi.ajp.164.6.942.
    1. Froehlich TE, Lanphear BP, Epstein JN, Barbaresi WJ, Katusic SK, Kahn RS. Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. 2007;14(9):857–864. doi: 10.1001/archpedi.161.9.857.
    1. Cowan LD. The epidemiology of the epilepsies in children. Ment Retard Dev Disabil Res Rev. 2002;14:171–181. doi: 10.1002/mrdd.10035.
    1. Hooker WD, Raskin NH. Neuropsychologic alterations in classic and common migraine. Arch Neurol. 1986;14:709–712. doi: 10.1001/archneur.1986.00520070065020.
    1. Calandre EP, Bembibre J, Arnedo ML, Becera D. Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients: their relationship with the clinical manifestations of the illness. Cephalalgia. 2002;14:291–302. doi: 10.1046/j.1468-2982.2002.00370.x.
    1. Mongini F, Keller R, Deregibus A, Barbalonga E, Mongini E. Frontal lobe dysfunction in patients with chronic migraine: a clinical-neuropsychological study. Psychiatry Res. 2005;14:101–106. doi: 10.1016/j.psychres.2003.12.028.
    1. Pearson AJ, Chronicle EP, Maylor EA, Bruce LA. Cognitive function is not impaired in people with a long history of migraine: a blinded study. Cephalalgia. 2006;14:74–80. doi: 10.1111/j.1468-2982.2005.01001.x.
    1. Waldie KE, Welch D. Cognitive function in tension type headache. Curr Pain Headache Rep. 2007;14:454–460. doi: 10.1007/s11916-007-0233-1.
    1. Strine TW, Okoro CA, McGuire LC, Balluz LS. The associations among childhood headaches, emotional and behavioral difficulties, and health care use. Pediatrics. 2006;14(5):1728–1735. doi: 10.1542/peds.2005-1024.
    1. Mazzone L, Vitiello B, Incorpora G, Mazzone D. Behavioral and temperamental characteristics of children and adolescents suffering from primary headache. Cephalalgia. 2006;14(2):194–201. doi: 10.1111/j.1468-2982.2005.01015.x.
    1. Aromaa M, Rautava P, Helenius H, Silanpaa M. Factors of early life as predictors of headache in children at school entry. Headache. 1998;14(1):23–30. doi: 10.1046/j.1526-4610.1998.3801023.x.
    1. Carlsson J. Prevalence of headaches in schoolchildren: relation to family and school factor. Acta Paediatr. 1996;14:692–696. doi: 10.1111/j.1651-2227.1996.tb14128.x.
    1. Headache Classification Committee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;14(Suppl 1):9–160.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition (DSM-IV) Washington, DC: American Psychiatric Publishing; 2000.
    1. Conners C. Conners’ rating scale-revised. Tonawanda, NY: Multi-Health Systems Publishing; 1997.
    1. Margalit M. The Committee for examination of extraction ability of students with learning disabilities., 1997. Ministry of Health, Israel Government Available at: . (2002 accessed 20 June 2012)
    1. Leviton A. Do learning handicaps and headache cluster? J Child Neurol. 1986;14:372–377. doi: 10.1177/088307388600100411.
    1. Arruda MA, Guidetti V, Galli F, Albuquerque RC, Bigal ME. Migraine, tension-type headache, and attention-deficit/hyperactivity disorder in childhood: a population-based study. Postgrad Med. 2010;14(5):18–26. doi: 10.3810/pgm.2010.09.2197.
    1. Villa TR, Correa Moutran AR, Sobirai Diaz LA. et al.Visual attention in children with migraine: a controlled comparative study. Cephalalgia. 2009;14:631–634. doi: 10.1111/j.1468-2982.2008.01767.x.
    1. Riva D, Aggio F, Vago C. et al.Cognitive and behavioural effects of migraine in childhood and adolescence. Cephalalgia. 2006;14:596–603. doi: 10.1111/j.1468-2982.2006.01072.x.
    1. Riva D, Usilla A, Aggio F. et al.Attention in children and adolescents with headache. Headache. 2012;14:374–384. doi: 10.1111/j.1526-4610.2011.02033.x.
    1. Young WB, Peres MF, Rozen TD. Modular headache theory. Cephalalgia. 2001;14:842–849. doi: 10.1046/j.1468-2982.2001.218254.x.
    1. Camarda C, Monastero R, Pipia C, Recca D, Camarda R. Interictal executive disfunction in migraineurs without aura: relationship with duration and intensity o attacks. Cephalalgia. 2007;14:1094–1110. doi: 10.1111/j.1468-2982.2007.01394.x.
    1. D’Andrea G, Nertempi P, Ferro Milone F, Joseph R, Cananzi JR. Personality and memory in childhood migraine. Cephalalgia. 1989;14:25–28.
    1. Waldie KE, Hausmann M, Milne BJ, Poulton R. Migraine and cognitive function: a life-course study. Neurology. 2002;14:904–908. doi: 10.1212/WNL.59.6.904.
    1. Haverkamp F, Honscheid A, Muller-Sinik K. Cognitive development in children with migraine and their unaffected siblings. Headache. 2002;14:776–779. doi: 10.1046/j.1526-4610.2002.02179.x.
    1. Borge AI, Nordhagen R. Development of stomach-ache and headache during middle childhood: co-occurrence and psychological risk factors. Acta Paediatr. 1995;14(7):795–802. doi: 10.1111/j.1651-2227.1995.tb13759.x.
    1. Berkson J. Limitations of the application of fourfold table analysis to hospital data. Biometrics. 1946;14:47–53. doi: 10.2307/3002000.

Source: PubMed

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