The prevalence and triggers of various headache types in Finnish children at school entry and age 6 years were investigated at the University of Turku, Finland. Questionnaires sent to 1132 families with 6-year-old children revealed 96 children with headache disturbing their daily activities. Migraine was diagnosed in 55% and tension-type headache in 36%. The headache group and an asymptomatic control group were interviewed and examined. Compared to controls, those with headache had significantly more bruxism, occipital and temporomandibular joint tenderness, and more travel sickness. Triggers of headache included fatigue and sleep deprivation (72%), excitement (65%), fever (64%), sun overexposure (62%), exercise (49%), ice cream (23%), anxiety, chocolate, and carbonated drinks. Children with migraine compared to those with tension headaches had more headaches triggered by ice cream, fear, or anxiety (28-36% cf 9-13%), more frequent abdominal pain (40% cf 11%), they took medication more frequently for pain relief, and were more often absent from day care. Pain-relieving factors, darkened room, vomiting, and medication, were more beneficial in migraine than tension headaches. [1]

COMMENT. Palpation of occipital muscles and temporomandibular joints may uncover causes of tension-type headaches in children, leading to effective therapy. Headache triggers are especially frequent in migraine sufferers. Relief may be obtained by sleep and rest (95%), darkened room (58%), vomiting (16%), eating (29%), and medication (83%), most commonly ibuprofen.