Headache in children.

Headache is an extremely frequent symptom in childhood and adolescence, and a common reason for neurological consultation. The prevalence of primary headaches (about 85% in tertiary centers) ranges from 10% to 20% in schoolchildren, and increases with increasing age. No sex difference is apparent until age 11. Female preponderance begins about age 12; during adolescence the female-to-male ratio is about 2:1. A child is not a "little adult" and many developmental and individual factors affect headaches, pertaining to the clinical expression, diagnosis, and therapy of the primary headache. According to this view, several points have to be clarified, beginning by considering the child as a whole as regards his or her development, taking into account neurobiological and psychological maturational processes, familial, social, and environmental factors, and avoiding an adult-focused approach to the disease. It is necessary to find key points in the etiology, pathogenesis, diagnosis, treatment, and outcome of headache in childhood and adolescence.