Diagnosing secondary headache in children may need new approach – Healio

By | July 11, 2019

PHILADELPHIA — Some of the common symptoms used to determine if a child or teenager is experiencing a secondary headache may no longer be reliable, according to an abstract presented at the American Headache Society Annual Scientific Meeting.

“The literature has begun to question the validity of some of the common red flags as true indicators of a more serious disease or condition. Unnecessarily classifying certain symptoms as red flags could lead to children receiving nonessential neuroimaging, or unnecessary concern within the family,” Gerardo Velasquez, BA, wrote in an abstract.

He reviewed 43 studies to ascertain if the SNOOP4Y mnemonic used in pediatric patients with migraine — (S)ystemic symptoms, (N)eurological symptoms, sudden (O)nset, (O)ccipital location, (P)rogressive symptoms, (P)recipitation by Valsalva maneuver, (P)ositional aspect, lack of (P)arental history, and (Y)ears of age — still had clinical purpose.

He found that patients with systemic and neurological symptoms, early morning headaches and aged 6 years or younger had the most evidence to warrant screening.

Child, Mother, At Doctor But Not Happy 

Some of the common symptoms used to determine if a child or teenager is experiencing a secondary headache may no longer be reliable, according to an abstract presented at the American Headache Society Annual Scientific Meeting.

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Velasquez added that conversely, studies that discussed occipital location did not “clearly demonstrate it to be a risk factor for secondary headache [and] there are limited data on a sudden onset, precipitation by Valsalva, positional aspect and lack of parental history as being risk factors.”

“Many of these studies are limited by small sample sizes, failure to include a range of secondary headache diagnoses, and a lack of analyses beyond the prevalence in a sample. Modification of the SNOOP4Y mnemonic is warranted given the pediatric literature,” Velasquez concluded. – by Janel Miller

Reference: Velasquez G. Risk factors for secondary headache in children and adolescents: A systematic review. Presented at: American Headache Society Annual Scientific Meeting; July 11-14, 2019; Philadelphia.

Disclosures: Healio Primary Care was unable to determine the author’s relevant financial disclosures prior to publication.

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