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Karvounides D, Marzouk M, Ross AC, VanderPluym JH, Pettet C, Ladak A, Ziplow J, Patterson Gentile C, Turner S, Anto M, Barmherzig R, Chadehumbe M, Kalkbrenner J, Malavolta CP, Clementi MA, Gerson T, Szperka CL. The intersection of COVID-19, school, and headaches: Problems and solutions. Headache 2021; 61:190-201. [PMID: 33382459 PMCID: PMC8086994 DOI: 10.1111/head.14038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/12/2020] [Accepted: 11/12/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To equip clinicians with recommendations specific to concerns related to the novel coronavirus disease 2019 (COVID-19), which impact the physical, emotional, and social health of youth with headache disorders. BACKGROUND COVID-19 has affected societies on a global scale including children and youth with chronic headache disorders. Many concerns are predicted to arise in the 2020-2021 school year, whether classes are conducted in-person or virtually. METHODS Clinical impressions were combined with a review of the literature, although limited due to the recent nature of this issue. RESULTS We describe recommendations to support caregivers and youth as they face changes expected with the return to school in the fall of 2020. CONCLUSION Although there are significant concerns for caregivers and youth with migraine given the context of changes related to the pandemic, there are many recommendations that can help minimize exacerbations of the physical, emotional, and social health of youth with chronic migraine.
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Affiliation(s)
- Dina Karvounides
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maya Marzouk
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Alexandra C Ross
- UCSF Benioff Children's Hospital, University of California, San Francisco, CA, USA
| | | | | | - Ali Ladak
- Penn Therapy & Fitness, University City, Philadelphia, PA, USA
| | - Jason Ziplow
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carlyn Patterson Gentile
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Scott Turner
- Department of Neurology, University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA
| | - Marissa Anto
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rebecca Barmherzig
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Madeline Chadehumbe
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jocelyn Kalkbrenner
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carrie P Malavolta
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michelle A Clementi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Trevor Gerson
- Division of Child Neurology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Christina L Szperka
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Concussion and mild traumatic brain injury are common injuries in pediatrics, and posttraumatic headache is the most common complaint following them. Although most children and teens recover from a simple, isolated concussion without incidents within 1-2 weeks, some develop symptoms that can last for months. It is important to manage both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, and maximize function. In this article, we review the definitions, epidemiology, and current recommendations for the evaluation and treatment of acute and persistent posttraumatic headaches. Although this is still a developing field and there is much that we still need to learn about concussion and the best strategies to prevent and treat these injuries and their sequelae, we hope that this review will help providers to understand the current evidence and treatment recommendations to improve care for children with concussion and mild traumatic brain injury.
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Komazaki Y, Fujiwara T, Ogawa T, Sato M, Suzuki K, Yamagata Z, Moriyama K. Association between malocclusion and headache among 12- to 15-year-old adolescents: a population-based study. Community Dent Oral Epidemiol 2014; 42:572-80. [PMID: 24954448 DOI: 10.1111/cdoe.12111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 05/02/2014] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Headaches are a common problem among adolescents, and malocclusion is a possible risk factor. The purpose of this study was to investigate the association between malocclusion and headache among Japanese adolescents aged 12-15 years using a population-based sample. METHODS A total of 938 adolescents (94.7% of the target population in Koshu City) participated. A modified version of the Index of Orthodontic Treatment Need (IOTN) was used by orthodontists to evaluate occlusal characteristics, and the frequency of headaches (none, rarely, sometimes) was assessed via questionnaire (N = 938). Ordered logistic regression analyses were used to analyze the association between malocclusion and headache. RESULTS The prevalence of malocclusion diagnosed using the modified version of the IOTN was 44.9%. Multiple ordered logistic regression analyses showed that the odds ratio (OR) of having malocclusion for headache was 1.38 (95% confidence interval [CI]: 1.06-1.80), after adjustment for demographics, lifestyle, and dental status including orthodontic treatment history and tooth size. Moreover, among occlusal traits, lower crowding was independently associated with headache (OR: 1.64, 95% CI: 1.07-2.51). CONCLUSIONS We found that malocclusion, especially lower crowding, was associated with headache in a population-based sample of adolescents aged 12-15 years in Japan. Further study is needed to elucidate the mechanisms by which malocclusion affects headache.
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Affiliation(s)
- Yuko Komazaki
- Section of Maxillofacial Orthognathics Department of Maxillofacial Reconstruction and Function, Division of Maxillofacial/Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
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Sheridan DC, Spiro DM, Meckler GD. Pediatric migraine: abortive management in the emergency department. Headache 2013; 54:235-45. [PMID: 24512575 DOI: 10.1111/head.12253] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2013] [Indexed: 12/23/2022]
Abstract
Studies suggest that headache accounts for approximately 1% of pediatric emergency department (ED) visits. ED physicians must distinguish between primary headaches, such as a tension or migraine, and secondary headaches caused by systemic disease including neoplasm, infection, or intracranial hemorrhage. A recent study found that 40% of children presenting to the ED with headache were diagnosed with a primary headache, and 75% of these were migraine. Once the diagnosis of migraine has been made, the ED physician is faced with the challenge of determining appropriate abortive treatment. This review summarizes the most recent literature on pediatric migraine with an emphasis on diagnosis and abortive treatment in the ED.
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Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine/Pediatrics, Oregon Health & Science University, Portland, OR, USA
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Spontaneous intracranial hypotension in childhood and adolescence. J Pediatr 2013; 163:504-10. [PMID: 23453548 DOI: 10.1016/j.jpeds.2013.01.055] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/14/2012] [Accepted: 01/24/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe the clinical and radiographic manifestations of spontaneous intracranial hypotension, a rarely diagnosed cause of headache in children. STUDY DESIGN This study included patients 19 years of age or younger evaluated between January 1, 2001, and June 30, 2012, for spontaneous intracranial hypotension. RESULTS We evaluated 24 children (18 girls and 6 boys) with spontaneous intracranial hypotension (age at onset of symptoms: 2-19 years, mean 14.3 years). Twenty-three patients presented with orthostatic headaches and 1 presented with a nonpositional headache. A generalized connective tissue disorder was diagnosed in 54% of patients. Magnetic resonance imaging showed the typical changes of spontaneous intracranial hypotension in most patients (79%). Spinal imaging demonstrated a cerebrospinal fluid (CSF) leak with or without an associated meningeal diverticulum in 12 patients (50%) and with dural ectasia or meningeal diverticula in 10 patients (42%), and it was normal in 2 patients (8%). Twenty-three patients initially underwent epidural blood patching, but 8 patients also were treated with percutaneous injections of fibrin glue and 11 patients eventually required surgical correction of the underlying CSF leak. There was no morbidity or mortality associated with any of the treatments, but 5 patients required acetazolamide for rebound high intracranial pressure headache. Overall, outcome was good in 22 patients (92%) and poor in 2 patients (8%). CONCLUSIONS Spontaneous intracranial hypotension in childhood is rare. Most patients can be treated effectively using a combination of epidural blood patching and percutaneous injections of fibrin glue or surgical CSF leak repair in refractory cases.
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