Headache disorders in children and adolescents are common. Bille<sup>2 Bille B. Migraine in school children Acta Paediatr 1962 ;  51 (suppl 136) : 1-151

Haga clic aquí para ir a la sección de Referencias</sup> noted that by 7 years of age, 1.4% of children had migraine, and by 15 years of age, this number had increased to 5.3%. Frequent nonmigraine headaches were present in 2.5% of 7-year-olds and 15.7% of 15-year-olds. Infrequent headaches were seen in 35% of 7-year-olds and 54% of 15-year-olds. Determining an appropriate system for diagnosis and classification of childhood headache is an important priority for clinical practice as well as clinical research. The criteria established by the International Headache Society (IHS)<sup>9 Headache Classification Committee of the International Headache Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain Cephalalgia 1988 ;  8 (suppl 7) : 1096

Haga clic aquí para ir a la sección de Referencias</sup> in 1988 represent a marked advance, although the criteria were developed primarily for headache disorders in adults. This classification has not been useful in young children. Revised criteria should provide an important tool for clinical practice, clinical trials, and epidemiologic research. In the IHS system, primary headache disorders are defined on the basis of symptom profiles and on the patterns of attack. The general medical examination and neurologic evaluation as well as diagnostic tests serve primarily to exclude secondary headache. The most common headache types in pediatric headache groups include migraine and tension headache.

Migraine is a heterogeneous disorder with attacks varying in pain intensity, duration, and pattern of associated features. The headaches may have exacerbations or remissions in children and often vary by sex and age of the individual. In children ages 4 to 7, migraine is more frequent in boys than in girls. Between the ages of 7 and 11, the prevalence is equal. From age 11, on the ratio changes to the classic 3 girls to 1 boy.<sup>23 Mortimer J., Kay J., Jaron A. Epidemiology of headache and childhood migraine in an urban general practice using ad hoc, Vahlquist and ISH criteria Dev Med Child Neurol 1992 ;  34 : 1095-1101

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Because of the changing headache patterns in this age group, it is difficult to perform long-term studies. Families often want to know what is going to happen in regard to their children's headaches. In the past, it was difficult to prognosticate. Sillanpaa and Antilla<sup>30 Sillanpaa M., Antilla P. Increasing prevalence of headache in 7-year-old school children Headache 1996 ;  36 : 466-470

Haga clic aquí para ir a la sección de Referencias</sup> followed a group of patients for more than 15 years and defined the differences between males and females who have headaches starting between ages 6 and 7. Males who fall into this category have a 24% chance of having migraine at age 22. Females have a 53.9% chance of having migraine at age 22 (Table 1). This age group is at risk for long-term difficulties with migraine and should be followed aggressively.