Pediatr Neurol. 2002 Aug;27(2):138-40
Childhood-onset cluster headache.
Lampl
C.
Department of Neurology; Psychiatry and Pain Center; General Hospital, Linz,
Austria.
Cluster headache, the most painful of the primary headaches, is a disorder with
well-known diagnostic criteria. The condition usually begins in the second
decade of life; the prevalence of childhood onset is approximately 0.1%. A
7-year-old female who suffered daily from severe strictly unilateral right
orbital attacks lasting approximately 30 minutes associated with autonomic
symptoms is reported herein. They were primarily misdiagnosed as psychogenic
headaches. There was no family history for migraine or cluster headaches;
physical and neurologic examinations and magnetic resonance imaging did not
suggest any association with head trauma or vascular disorders. After a negative
indomethacin test, daily intravenous administration of prednisolone terminated
the attacks on the third day of the treatment. According to the classification
and diagnostic criteria for headache disorders of the International Headache
Society the child fulfilled the criteria for episodic cluster headaches. The
pathogenesis, clinical manifestation, autonomic features, genetics, and family
history of cluster headaches during childhood are reviewed in this report.
Prophylactic medication and symptomatic treatment options are discussed,
especially concerning the rationale of use of steroids in children with cluster
headaches.
PMID: 12213616
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Headache. 1992 Jun;32(6):275-9.
Childhood onset cluster headaches.
Maytal J, Lipton RB, Solomon S, Shinnar S
Department of Neurology, Montefiore Medical Center, Bronx, New York.
Cluster headaches are rare in childhood. We identified 35 patients with cluster
headaches starting at or before 18 years of age, including 7 patients with onset
prior to age 10. All patients met the criteria of the International Headache
Society for episodic or chronic cluster headaches. Patients experienced cluster
headaches for as long as 20 years before seeking medical attention and required
many medical contacts to establish the correct diagnosis. The clinical features
of cluster headaches during childhood were similar to those which typically
occur in adult life. Cluster headache patterns changed over 18 years of follow
up. The frequency and duration of cluster periods increased in 14 subjects. The
frequency of single headache attacks during cluster periods also increased in a
similar number of subjects. We conclude that cluster headaches starting in
childhood or adolescence closely resemble the adult form of the disease. In many
patients, the frequency and duration of cluster periods and the frequency of the
individual headache episodes increased over time. Cluster headache represent a
treatable under-recognized cause of severe headaches in childhood and
adolescence.
PMID: 1399546
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