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Prevalence of headache and migraine in schoolchildren

Department of Medical Paediatrics, Royal Aberdeen Children's Hospital, Aberdeen AB9 2ZG Correspondence to: Dr I Abu-Arefeh, Department of child Health, University of Aberdeen, Aberdeen AB9 2ZD.

Abstract

Objectives : To determine the prevalence rates of the various causes of severe headache in school-children, with special emphasis on migraine and its impact on school attendance.
Design : Population based study in two stages, comprising an initial screening questionnaire followed by clinical interviews and examination of children with symptoms and a control group of asymptomatic children matched for age and sex.
Setting : 67 primary and secondary schools in the city of Aberdeen.
Subjects : 2165 children, representing a random sample of 10% of schoolchildren in Aberdeen aged 5-15 years.
Main outcome measures : (a) the prevalence of20migraine (International Headache Society criteria) and of other types of headache; (b) the impact of migraine on school attendance.
Results : The estimated prevalence rates of migraine and tension headache were 10.6% (95% confidence interval 9.1 to 12.3) and 0.9% (0.5 to 1.5) respectively. The estimated prevalence rates for migraine without aura and migraine with aura were 7.8% (95% confidence interval 6.5 to 9.3) and 2.8% (2.0 to 3.8) respectively. In addition, 10 children (0.7%) had headaches which, though lasting less than two hours, also fulfilled the International Headache Society criteria for migraine, 14 (0.9%) had tension headaches, and 20 (1.3%) had non-specific recurrent headache. The prevalence of migraine increased with age, with male preponderance in children under 12 and female preponderance thereafter. Children with migraine lost a mean of 7.8 school days a year due to all illnesses (2.8 days (range 0-80) due to headache) as compared with a mean of 3.7 days lost by controls.
Conclusions : Migraine is a common cause of headache in children and causes significantly reduced school attendance.

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