Of 577 children (3 to 18 years of age) evaluated over 34 months in the multidisciplinary Headache Center at Cincinnati Children’s Hospital Medical Center, 200 (35%) were diagnosed with chronic daily headache (CDH), having >15 headaches per month. Sixty-eight percent were girls, and 92% clinically had migraine headaches (60% met the International Headache Society criteria for migraine). Nausea with or without vomiting occurred in 64%, and photophobia and phonophobia in 60%. CDH were divided into 3 subcategories: 1) 37% with frequent but not daily headaches; 2) 44% having episodic daily headaches; and 3) 20% having a continuous headache. All subcategories, including the continuous group, most closely match the criteria for migraine. [1]

COMMENT. The nature of chronic daily headaches in children most closely match criteria for migraine, including the group with continous headaches. Many had analgesic rebound contributing to the CDH, especially in the daily continuous group. The quality of life was impacted, as evidenced by school absences and functional disability. However, those with CDH appear to learn coping skills more effectively than patients with less frequent headaches, especially while at school.