The role of the nurse clinician in recurrent childhood headache.

At least four percent of children have recurrent headaches and migraine is the most frequent cause. Migraine and tension-type headaches may co-exist. A variety of factors, specifically dietary and stressors (at home and at school) have been recognized as triggers. We have reviewed the role of the Neurosciences Nurse Clinician in the management of children with recurrent headaches in our Pediatric Neurology Outpatient Clinic. About 150 children with headache are seen in our clinic annually. The Nurse Clinician complements the Pediatric Neurologist's role in the following ways: 1) Provides educational material and reinforces the benign nature of the headache (i.e. absence of serious cause); 2) Discusses potential role for triggers; 3) Provides and emphasizes the importance of keeping a headache diary: teaches children and caregivers how triggers may be identified; 4) Makes follow-up telephone calls to determine changes in headache frequency/ severity. This approach minimizes the need for prophylactic medication (less than 25% of children we see require such treatment) and reduces the number of follow-up visits to Pediatric Neurologist and other physicians, thus minimizing health care costs.