Skip to main content

Table 21 Classification of headache in children

From: Reference programme: Diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 2nd Edition, 2012

1.1 [G43.0/N89] Migraine without aura

 A. A t least five attacks fulfilling criteria B–D

 B. Headache attacks lasting from 4 to 72 ha

 C. Headache has at least two of the following characteristics:

  1. Unilateral localisationb,c

  2. Pulsating quality

  3. Moderate or severe pain intensity

  4. Aggravation by or causing avoidance of routine physical activity such as climbing stairs

 D. During headache at least one of the following:

  1. Nausea and/or vomiting

  2. Phono- and photophobiad

 E. Not attributed to another disorder

1.2 [G43.1/N89] Migraine with aura

 Children and adults share the same diagnostic criteria

1.3.1 [G43.82/N89] Cyclic vomiting

 A. At least five attacks fulfilling criteria B–C

 B. Episodic attacks, stereotypical in the individual patient, of intense nausea and vomiting

lasting from 1 h to 5 days

 C. Vomiting during attacks occurs at least four times per hour for at least 1 h

 D. Symptom-free between attacks

 E. Not attributed to another disordere

1.3.2 [G43.820/N89] Abdominal migraine

 A. At least five attacks fulfilling criteria B–D

 B. Attacks of abdominal pain lasting 1–72 h (untreated or unsuccessfully treated)

 C. Abdominal pain with all of the following characteristics:

  1. Midline localisation, periumbilical or poorly localised

  2. Dull or “just sore” quality

  3. Moderate or severe intensity

 D. During the abdominal pain at least two of the following:

  1. Anorexia

  2. Nausea

  3. Vomiting

  4. Pallor

 E. Not attributed to another disorderf

The attacks are not caused by another conditionf

1.3.3 [G43.821/N89] Benign paroxysmal vertigo of childhood

 A. At least five attacks fulfilling criterion B

 B. Multiple episodes of severe vertigog, occurring without warning and resolving spontaneously after a few minutes to hours

 C. Normal neurological examination and audiometric and vestibular functions between attacks

 D. Normal electroencephalogram

2. [G44.2/N95] Tension-type headache

Children and adults share the same diagnostic criteria

  1. aIn children <15 years of age, the duration of an attack may be 1–72 h; the duration of untreated headache in children with a duration below 2 h should, however, be documented in a headache diary
  2. bMigraine headache is normally bilateral in small children; an adult pattern with unilateral pain is seen late in the adolescent period and in young adults
  3. cMigraine headache is typically frontotemporal. Occipital headache in children, be it unilateral or bilateral, is rare and requires diagnostic caution, as the cause may be structural lesions
  4. dIn small children photo- and phonophobia can be deducted from how the children react
  5. eCyclic vomiting is an exclusion diagnosis. Medical history, physical and neurological examination should not raise suspicion of any other condition. Thorough diagnostic assessment is always necessary to exclude any other condition. Differential diagnoses: intermittent bowel obstruction (malrotation); kidney, liver or pancreas disease; increased intracranial pressure; poisoning; metabolic disease and epilepsy
  6. fMedical history, and physical and neurological examinations should not provide signs of gastrointestinal or renal illness, otherwise such illness shall be excluded through relevant assessment programmes
  7. gOften associated with nystagmus or vomiting; unilateral throbbing headache may occur in some attacks
Back to article page

The Journal of Headache and Pain

ISSN: 1129-2377

Contact us