Valenta at the VI Baltic Congress for Children’s Neurology: We Need to Combat Headaches in Children and Adolescents

In June 2016, Valenta took part in the VI Baltic Congress for Children's Neurology held in St.-Petersburg.

Headache (HA) is a prevalent symptom in children and adolescents. According to researches, the incidence of HA increases from 3-8% in preschool children to 57-82% in adolescents¹. Children start to formulate their complaints of HA at the age of 4 to 5 years. By this age, a child obtains an ability to differently perceive, localize and correctly describe pain².

HA diagnostics includes revealing clinical displays of the disease, assessment of its neurological status, neurological visualization, and laboratory studies. Basic criteria of the disease severity indicating the need of patient’s hospitalization include: a sudden intensive headache; headache intensifying in time; morning and night HA accompanied with vomiting; combination of HA with localized symptoms lasting more than an hour; combination of headache with disturbances of consciousness or meningeal symptoms. At hospitalization, the patient needs to undergo general blood tests to check blood for anemia or reveal possible signs of inflammation; dynamic measurement of arterial pressure; ophthalmologic studies of eyeground, visual acuity, visual field loss, spasm of accommodation; USDG (status of cerebral hemodynamics); radiological examination of cervical spine with functional tests at suspicion of vertebral genesis of headaches. Doctors also prescribe to their patients to keep a pain diary, which facilitates cephalalgia diagnostics for specialists and gives opportunity to objectively assess the frequency of episodes, severity of headaches, the most frequent provoking factors and the quantity of analgetics the patient uses to reveal medication abusus. The diary helps the patient to make distinction between the types of cephalalgia³.

According to the International Classification of Headaches⁴, there is a primary headache with an individual nosology, and a secondary headache, which is a symptom of somatic pathology or a sign of underlying CNS disease. HA prevalence in adolescents is as following: 53% – tension-type headaches, 39% – migraines, 8% – other headaches⁵.

Tension headaches in children and adolescents are predominantly a display of school disadaptation. Healthcare professionals use the term “school headaches”⁶. Such headaches arise against the background of fatigue and are of diffused, compressing character. Etiology and pathogenesis of tension headaches still lack clarity, despite significant prevalence of this pathology. In these cases, headache is a result of irritation of sensitive nerve receptors of head muscles, which tone is strained in a state of tissue ischemia. Treatment for tension-type headaches presumes non-medication methods (osteopathy, MT, myofascial release, postisometric relaxation, massage, CFC), and physiotherapy (phototherapy, magnetotherapy, thermal treatment) in combination with vitamins and nootropics.

The second by prevalence type of HA – migraine – can be subdivided into two subtypes: hereditary-constitutional and symptomatic. The initial causes of migraines of the second subtype, which are displayed in childhood and adolescence, can be: cerebral aneurysm, trauma in labor, osteochondrosis, cranio vertebral anomalies, or anomalies of vertebral arteries. Migraine treatment should be primarily focused on relieving the attack by application of analgetics, non-steroid anti-inflammatory medications, or combined medicines containing caffeine⁷.Migraine preventive treatment is aimed at removal of provoking factors, and adherence to diet excluding food containing tyramine and phenylethylamine (hard cheese, nuts, citrus, soya products, red wine and beer). Besides, the patient should adhere to proper sleep regime and use non-pharmacological methods of relaxation (autogenic training, etc.). Medication preventive treatment can be applied in case of frequent, acute and protracted attacks accompanied by essential deterioration of health and restriction of daily activity.

Alexey Rogov, Head of Neuropsychology Business Unit, JSC “Valenta Pharm”: “According to WHO report, “Headaches and Public Health”, the increase of efficiency of treatment and preventive management of headaches in childhood and adolescence is one of priority problems of children's neurology. Valenta aspires to make an important contribution to improvement of therapy for such patients. Our portfolio in the sphere of neuropsychology contains medical products applied for children and adolescents to help them tackle various challenges, including headaches.”

• ¹Hershey A.D., Powers S.W., Winner P., Kabbouche M.A. Pediatric Headaches in Clinical Practice. – London: Wiley-Blackwell, 2009. – p.223.
• ²N.N.Zavadenko, Y.E.Nesterovsky. Headaches in Children and Adolescents: Clinical Features and Preventive Measures. Issues of Modern Pediatrics/2011/V.10/No.2, pp.162-169.
• ³A.P.Skoromets. Headaches in Children and Adolescents. Migraines. Headaches of Tension Type. I.I.Mechnikov SPbSPMU NWSMU.
• ⁴The International Classification of Headache Disorders. 2nd edition. Cephalalgia, 2004; 24 (Suppl 1): 9–160.
• ⁵Abu-Arafeh I., Razak S., Sivaraman B., Graham C. Prevalence of Headache and Migraine in Children and Adolescents: Systematic Review of Population-Based Studies. Dev Med Child Neurol, 2010; 52(12): 1088–1097.
• ⁶Bokonjich R., 1984.
• ⁷ Grazzi L., Andrasik F., Usai S. Pharmacological Behavioral Treatment for Children and Adolescents with Tension-Type Headache. NeurolSci, 2004;70-271.