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A clinical study on medication overuse headache in childhood and adolescence


There are few studies on Medication Overuse Headache (MOH) in children and no epidemiological studies on an Italian population. We evaluated the prevalence of MOH in patients referred to our Center in 2011.


We studied 118 patients looking for correlations between age of onset, sex, age at first contact, headache type, presence of Chronic Daily Headache (CDH), pain frequency, severity and presence of MOH (according to the revised criteria [1]) by Student’s t test, Pearson’s Chi Square and Mann-Whitney’s test were used to analyze data.


44.9% of the sample had a diagnosis of CDH. Among this group the prevalence of medication overuse was 20.8%. After 2 months of drug withdrawal 45.4% of the patients reported a significant improvement. No significant correlation was found between the presence of MOH and age of onset, sex, age at first contact, headache type, pain frequency and severity.


About 1/5 of children with CDH afferent to our Headache Unit are at high risk of worsening because of medication overuse. No previous studies showed a role for medication overuse in the etiopathogenesis of CDH in children and adolescents [2]. We suggest to keep in mind the possibility of medication overuse in children with headache and to investigate it carefully. Further studies are required to define a specific treatment protocol.


  1. Olesen J, Bousser MG, Diener HC, Dodick D, First M, Goadsby PJ, Göbel H, Lainez MJ, Lance JW, Lipton RB, Nappi G, Sakai F, Schoenen J, Silberstein SD, Steiner TJ: New appendix criteria open for a broader concept of chronic migraine. Cephalalgia 2006, 26(6):7412–746.

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  2. Galli F, Patron L, Russo PM, Bruni O, Ferini-Strambi L, Guidetti V: Chronic daily headache in childhood and adolescence: clinical aspects and a 4-year follow-up. Cephalalgia 2004, 24(10):850–858. 10.1111/j.1468-2982.2004.00758.x

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Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Piazza, F., Chiappedi, M., Maffioletti, E. et al. A clinical study on medication overuse headache in childhood and adolescence. J Headache Pain 14 (Suppl 1), P27 (2013).

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