Headaches. They are not supposed to occur in small children, at least that is what we are taught in medical school. In residency we learn that they indeed do occur in children, but all too often management decisions are left to a neurologist. In practice, this malady occurs quite often, and in today's financially austere medical milieu, it will be up to the primary care provider to appropriately diagnose, manage, and follow these patients. This issue of Pediatric Annals gives the reader a comprehensive review of recurrent pediatric headache from etiology to management.
After review of this issue, the reader should: I ) have a better understanding of the proposed etiologies, pathophysiology and diagnosis of recurrent childhood headaches, and 2) be better prepared to manage this disorder in the outpatient setting with pharmacologic or behavioral therapy techniques.
HOW TO OBTAIN CME CREDITS BY READING THIS ISSUE
Pediatricians can receive Category I credits for the Physician's Recognition Award of the American Medical Association by reading the following articles and successfully completing the quiz at the end of the issue. Complete instructions are given on the quiz pages.
The Pretest below has been prepared to assist you in studying the following material. It indicates some of the areas to be covered and will make it possible for you to challenge your present knowledge of the material before reading further.
1. The headache associated with a brain tumor may mimic other headache syndromes, but it is characteristically nonpulsatile, deeply aching, and intermittent.
2. Verapamil is an ineffective prophylactic agent for migraine headaches.
3. Parents of children with recurrent headaches have been found to focus more on achievement and have higher expectations than parents of unaffected children.
4. The behavioral treatment of headache by the primary care physician is underused, but likely is easily accepted by most parents.
Answers to the Pretest:
1.A 2. B 3. B 4.A