6280 Should paediatric headache clinics be established in all NHS hospitals?

Objectives To gather evidence supporting the development and delivery of specialised headache services among hospitals providing care for children and young people. Methods This is an observational hospital-based clinical study of consecutive patients referred to our local paediatric headache clinic. A detailed headache history was obtained via structured, thorough interviews with each patient and, if needed, the patient's own diary. Headache diagnosis was based on the IHDC 2013.¹ The primary outcome measures were frequent headaches, defined as more than 1 per month, severity (prohibition of daily life activity because of headaches), prolonged headaches where the pain lasted over 4 hours and school disruption. Results 2124 patients were included in this study. 1200 (56.5%) of patients were female and 924 (43.5%) male, of whom 1278 (60.2%) were Caucasian and 846 (39.8%) of another ethnic origin. The average age was 11.5 years (range 0.9 – 17.9). Headaches were primary (n = 1849, 87%), secondary (n = 60, 3%) and unspecified (n = 215, 10%). Family history of headaches was identified among 1069 (50.9%) of patients. Headaches were severe (n = 1347, 63.5%), frequent (n = 1755, 83.9%) and lasting over 4 hours (n = 1166, 57.7%). 1286 (63.6%) of children experienced school disruption. Examination of the occurrences of one or more of the primary outcome measures (frequent, severe and or headaches lasting more than 4 hours) showed the following (table 1): Conclusion Our findings demonstrate the significant impact of severe, frequent, and prolonged headaches in children, subsequently resulting in considerable school disruption. To address this issue effectively, headache clinics as secondary specialised services need to be established within all hospitals. Reference The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.