Primary Headache in Children and Adolescents: From Pathophysiology to Diagnosis and Treatment

Primary headaches are common disorders among children and adolescents; tension type headaches (TTH) and migraine being the most frequent types. This paper reviews the literature and summarizes the knowledge regarding the underlying pathophysiological mechanisms that cause headaches, mainly TTH and migraine, discusses the diagnostic criteria for primary headaches, and the different moralities for management of pain in children and adolescents. It is well accepted, that the pain experience holds bio-psychosocial components to it, therefore treatment strategies should be tailored according to the patient’s age, headache diagnosis, family structure, culture and beliefs, and according to the disability the headache imposes on the patient’s daily living. A multidisciplinary treatment, that includes counseling, education and reassurance combined with pharmacological and non-pharmacological treatment, was found to be the effective strategy to alleviate the symptoms of primary headaches in children and adolescents.