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Friday, April 07, 2006

Don't Ignore Migraines in Teenagers

April 5, 2006 (San Diego) -- If your teenager constantly complains of a headache, don't write it off as an excuse to skip a day of school or avoid the day's chores, Florida researchers advise.

A nationwide study of 18,714 adolescents aged 12 to 19 shows that migraine headaches in teenagers are common, disabling, and substantially undertreated.

"If your adolescent has a headache, they more than likely are really having a headache," says researcher Paul Winner, MD, director of the Palm Beach Headache Clinic and professor of neurology, Nova Southeastern University, Fort Lauderdale, Fla. "Headaches are causing a lot of disability in the nation's youths."

Findings of a nationwide survey not only show that a large number of adolescents have migraine headaches, but they aren't receiving appropriate treatment for those debilitating headaches. The results were presented at the American Academy of Neurology (AAN) 58th annual meeting.

The study found that for a one-year period, 5% of boys and 7.7% of girls reported frequent migraines.

Migraine Medications

About 60% of those with migraines were using only over-the-counter medications to alleviate the symptoms. Only 17% used prescriptions drugs for migraines and 22% used both prescription and over-the-counter medication.

Almost one-third of adolescents with migraines met the criteria of severity and frequency of headache for taking medications to prevent migraines; even so, the majority was not receiving those medications.

Thirty-one percent met the criteria to warrant preventive therapy. Yet of those who met the criteria for preventive therapy, only 19% had used preventive medicine previously and only 10.6% were current users.

"There was a lot more disability than what we expected," Winner tells WebMD. "The fact that 31% of these kids were eligible for preventive care is enormous. That represents a lot of pain, suffering, and loss of school and family activities."

Increasing Frequency of Migraines

The study sent out questionnaires to 120,000 households that were representative of the U.S. population. Surveys were returned by 77,879 households that yielded data on 18,714 adolescents. Migraine cases were established by national guidelines on headache criteria. Migraine sufferers who were candidates for preventive therapy were determined by an expert panel of neurologists using AAN guidelines.

The researchers found that the frequency of migraine headaches among adolescent sufferers continued to "rapidly" increase. "The child initially might have one or two headaches a month and then a couple of years later have 10 or 15 headaches a month," Winner says. "They seem to transition quickly. These kids need help."

The study also showed that girls starting at age 14 and both male and female adolescents from poorer families earning less than $22,500 annually had higher rates of migraine headaches, according to Winner.

Advice for Parents

Winner advises parents of children with frequent headaches to seek help from their doctors and that adolescents talk with their parents and doctors about frequent headaches. "The child needs to know that it isn't normal to have a really severe headache," he says. "That is not a normal state."

Migraine headaches are less common in childhood and reach higher levels in adulthood, so the percentage of adolescents with migraines isn't surprising, notes J.D. Bartleson, MD, associate professor of neurology, Mayo Clinic College of Medicine.

"What is more surprising is that migraine headaches in adolescents are underrecognized and undertreated," Bartleson tells WebMD.

Bartleson says there needs to be better public awareness that both acute symptomatic and preventive treatment is available for migraine headaches.

SOURCES: American Academy of Neurology 58th annual meeting, San Diego, April 1-8, 2006. Paul Winner, MD, director, Palm Beach Headache Clinic; professor of neurology, Nova Southeastern University, Fort Lauderdale, Fla. J.D. Bartleson, MD, associate professor of neurology, Mayo Clinic College of Medicine.


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