Headache-related Disability and Predictor of Disability in Children and Adolescent

Purpose: To estimate headache-related disability and to identify predictor of disability in children and adolescent with headache. In addition, to assess the improvement of disability after treatment. Method: We conducted a retrospective analysis of clinical records of children and adolescents who were presented with headache at the Chosun University Hospital between January 2010 and December 2014. Headache-related disabilities were valuated using the 6-question Pediatric Migraine Disability Assessment (PedMIDAS). The headaches were classified according to the International Classification of Headaches Disorders-II (ICHD-II). Results: A total of 307 patients were identified : 117 boys and 190 girls with a mean age of 11.3 years (range 6-18 years). About 17% of patients had a grade III-IV disability. There is a trend towards more severe disabilities in older age groups, especially in the 16-18 year-olds. The migraine patients have the highest PedMIDAS scores (19.926.6), whereas, the other headache patients have the lowest scores (7.916.0). This is higher score and severe disability at home activity (3.57.4) than school (2.44.2) and play, social or leisure activity (2.97.7). The predictors of disability due to headache are migraine, frequent headache and longer duration of symptom before presentation. Mean PedMIDAS score is significantly improved by treatment (P=0.002). Conclusion: A considerable number of children and adolescents with headache had a moderate to severe disability. The migraine patients have the worst disability. This study demonstrated that migraine, frequent headache and longer duration of symptom before presentation are the predictors of headache-related disability and a proper preventive treatment can improve the quality of life of pediatric headache patients.