Prevalence of headache and migraine in schoolchildren.

OBJECTIVES

To determine the prevalence rates of the various causes of severe headache in schoolchildren, with special emphasis on migraine and its impact on school attendance.

DESIGN

Population based study in two stages, comprising an initial screening questionnaire followed by clinical interviews and examination of children with symptoms and a control group of asymptomatic children matched for age and sex.

SETTING

67 primary and secondary schools in the city of Aberdeen.

SUBJECTS

2165 children, representing a random sample of 10% of schoolchildren in Aberdeen aged 5-15 years.

MAIN OUTCOME MEASURES

(a) the prevalence of migraine (International Headache Society criteria) and of other types of headache; (b) the impact of migraine on school attendance.

RESULTS

The estimated prevalence rates of migraine and tension headache were 10.6% (95% confidence interval 9.1 to 12.3) and 0.9% (0.5 to 1.5) respectively. The estimated prevalence rates for migraine without aura and migraine with aura were 7.8% (95% confidence interval 6.5 to 9.3) and 2.8% (2.0 to 3.8) respectively. In addition, 10 children (0.7%) had headaches which, though lasting less than two hours, also fulfilled the International Headache Society criteria for migraine, 14 (0.9%) had tension headaches, and 20 (1.3%) had non-specific recurrent headache. The prevalence of migraine increased with age, with male preponderance in children under 12 and female preponderance thereafter. Children with migraine lost a mean of 7.8 school days a year due to all illnesses (2.8 days (range 0-80) due to headache) as compared with a mean of 3.7 days lost by controls.

CONCLUSIONS

Migraine is a common cause of headache in children and causes significantly reduced school attendance.