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Article: Recurrent headache in Chinese children: Any agreement between clinician diagnosis and sympton-based diagnoses using the International Classification of Headache Disorders (second edition)?

TitleRecurrent headache in Chinese children: Any agreement between clinician diagnosis and sympton-based diagnoses using the International Classification of Headache Disorders (second edition)?
Authors
Issue Date2006
PublisherSage Publications, Inc.. The Journal's web site is located at http://jcn.sagepub.com
Citation
Journal Of Child Neurology, 2006, v. 21 n. 2, p. 132-138 How to Cite?
AbstractThere has been a lack of published data on the pattern of recurrent headache in Chinese children. The validity of the International Classification of Headache Disorders criteria has not been evaluated in Chinese children. We performed a retrospective medical record review of 124 children aged < 18 years with an International Classification of Diseases coding of headache followed up in a general outpatient clinic in a university-based hospital over a 3-year period (2000-2002). The aims of our study were to (1) study the pattern of recurrent headache in Chinese children and (2) study any agreement between clinical diagnoses made by our board-certified pediatricians and symptom-based diagnoses using the second edition of the International Classification of Headache Disorders (International Classification of Headache Disorders-II). The most common type was unclassified headache (70.2%), followed by infrequent episodic tension-type headache (24.2%) and migraine without aura (5.6%). A family history of headache or migraine was more commonly found in children with infrequent episodic tension-type headache or migraine without aura. (P = .0109) The co-occurrence of abdominal pain with infrequent episodic tension-type headache was 30%; for unclassified headache, it was 19.5%. Dysmenorrhea occurred in 7.1% of girls with infrequent episodic tension-type headache and 8.6% of girls with unclassified headache. However, migraine without aura was not associated with abdominal pain or dysmenorrhea. Children with migraine without aura were more frequently referred to child neurologists (P = .0207) and admitted (P = .0000). Neurologic investigations, including electroencephalography, computed tomography, or magnetic resonance imaging of the brain, were performed in less than 30% of cases. Abnormal results were found in only seven cases; with two referred to a neurosurgeon and none requiring surgical intervention. Thus, by using the clinical diagnosis of our board-certified pediatricians as the standard, the sensitivity and specificity of International Classification of Headache Disorders-II-based definition of migraine without aura was 23.1% and 93.4%, respectively, and for infrequent episodic tension-type headache, it was 37.5% and 76%, respectively. The typical characteristics of migraine tend to emerge later and might have led to underdiagnosis of the younger age group, with a higher rate of referral and inpatient management. The new edition of the International Classification of Headache Disorders criteria is still restrictive in clinical practice and might not be able to reflect current pediatric practice. Further studies with a defined study period or recurrent headache might be more useful in analyzing the use of these new International Classification of Headache Disorders criteria in the diagnosis of recurrent headache in children.
Persistent Identifierhttp://hdl.handle.net/10722/143540
ISSN
2015 Impact Factor: 1.434
2015 SCImago Journal Rankings: 0.694
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, TYPen_HK
dc.contributor.authorWong, Ven_HK
dc.date.accessioned2011-12-12T03:51:38Z-
dc.date.available2011-12-12T03:51:38Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Child Neurology, 2006, v. 21 n. 2, p. 132-138en_HK
dc.identifier.issn0883-0738en_HK
dc.identifier.urihttp://hdl.handle.net/10722/143540-
dc.description.abstractThere has been a lack of published data on the pattern of recurrent headache in Chinese children. The validity of the International Classification of Headache Disorders criteria has not been evaluated in Chinese children. We performed a retrospective medical record review of 124 children aged < 18 years with an International Classification of Diseases coding of headache followed up in a general outpatient clinic in a university-based hospital over a 3-year period (2000-2002). The aims of our study were to (1) study the pattern of recurrent headache in Chinese children and (2) study any agreement between clinical diagnoses made by our board-certified pediatricians and symptom-based diagnoses using the second edition of the International Classification of Headache Disorders (International Classification of Headache Disorders-II). The most common type was unclassified headache (70.2%), followed by infrequent episodic tension-type headache (24.2%) and migraine without aura (5.6%). A family history of headache or migraine was more commonly found in children with infrequent episodic tension-type headache or migraine without aura. (P = .0109) The co-occurrence of abdominal pain with infrequent episodic tension-type headache was 30%; for unclassified headache, it was 19.5%. Dysmenorrhea occurred in 7.1% of girls with infrequent episodic tension-type headache and 8.6% of girls with unclassified headache. However, migraine without aura was not associated with abdominal pain or dysmenorrhea. Children with migraine without aura were more frequently referred to child neurologists (P = .0207) and admitted (P = .0000). Neurologic investigations, including electroencephalography, computed tomography, or magnetic resonance imaging of the brain, were performed in less than 30% of cases. Abnormal results were found in only seven cases; with two referred to a neurosurgeon and none requiring surgical intervention. Thus, by using the clinical diagnosis of our board-certified pediatricians as the standard, the sensitivity and specificity of International Classification of Headache Disorders-II-based definition of migraine without aura was 23.1% and 93.4%, respectively, and for infrequent episodic tension-type headache, it was 37.5% and 76%, respectively. The typical characteristics of migraine tend to emerge later and might have led to underdiagnosis of the younger age group, with a higher rate of referral and inpatient management. The new edition of the International Classification of Headache Disorders criteria is still restrictive in clinical practice and might not be able to reflect current pediatric practice. Further studies with a defined study period or recurrent headache might be more useful in analyzing the use of these new International Classification of Headache Disorders criteria in the diagnosis of recurrent headache in children.en_HK
dc.languageengen_US
dc.publisherSage Publications, Inc.. The Journal's web site is located at http://jcn.sagepub.comen_HK
dc.relation.ispartofJournal of Child Neurologyen_HK
dc.subject.meshAdolescenten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAsian Continental Ancestry Group/*psychology/statistics & numerical dataen_US
dc.subject.meshChilden_US
dc.subject.meshDiagnosis, Differentialen_US
dc.subject.meshElectroencephalographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeadache Disorders/*classification/*diagnosis/epidemiology/psychologyen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.mesh*International Classification of Diseasesen_US
dc.subject.meshMaleen_US
dc.subject.meshMigraine without Aura/classification/diagnosis/epidemiology/psychologyen_US
dc.subject.meshNeurologic Examinationen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshReferral and Consultationen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSex Factorsen_US
dc.subject.meshStatistics as Topicen_US
dc.subject.meshTension-Type Headache/classification/diagnosis/epidemiology/psychologyen_US
dc.titleRecurrent headache in Chinese children: Any agreement between clinician diagnosis and sympton-based diagnoses using the International Classification of Headache Disorders (second edition)?en_HK
dc.typeArticleen_HK
dc.identifier.emailWong, V:vcnwong@hku.hken_HK
dc.identifier.authorityWong, V=rp00334en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1177/08830738060210020101en_HK
dc.identifier.pmid16566877-
dc.identifier.scopuseid_2-s2.0-33646848897en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646848897&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue2en_HK
dc.identifier.spage132en_HK
dc.identifier.epage138en_HK
dc.identifier.isiWOS:000237831900008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, TYP=13611255700en_HK
dc.identifier.scopusauthoridWong, V=7202525632en_HK

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