Clinical and Pathophysiological Peculiarities of Headache in Children and Adolescents

Headache has a huge prevalence in pediatric age. It is probably the most frequent neurological symptom because of which children and adolescents are referred to a doctor. However, there is only a weak attention to the peculiarities that the different types of headaches show at this age, often considering the headache of children and adolescents only a mere precursor of a far more severe symptom of adults. This is a mistake for both primary and secondary headaches. For the latter, the possible causes of headache can be deeply different in children and adolescents from those recognized in adulthood. The specificity is even higher for the primary headaches. First, the clinical characteristics of migraine and tension-type headaches (the most frequent types of primary headaches) are very different between adults and children, especially the youngest ones. Second, there is evidence that also the pathophysiological mechanisms can vary according to age. Third, the treatment of primary headaches may also be peculiar in the pediatric population, where the placebo effect can be so powerful as to prevent the treatments commonly used in adults to be proven effective.

The main purpose of the present Research Topic is to collect clinical observations and experimental evidences supporting the peculiarity of headaches at this early stage of life. We believe that removing the idea that headache in children is only a "small" headache, can lead to a better pathophysiological definition and the development of specific treatments.