Pediatric hypnic headache: a systematic review
IntroductionHypnic headache (HH) is a primary headache, and it is considered a rare condition in children. The underlying mechanisms of HH are not yet fully understood. This systematic review aims to provide a comprehensive description of the clinical features of all published cases of pediatric HH....
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1254567/full |
| _version_ | 1827866725268324352 |
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| author | Alessandro Ferretti Margherita Velardi Claudia Fanfoni Giovanni Di Nardo Melania Evangelisti Thomas Foiadelli Alessandro Orsini Marco Del Pozzo Gianluca Terrin Umberto Raucci Pasquale Striano Pasquale Striano Pasquale Parisi |
| author_facet | Alessandro Ferretti Margherita Velardi Claudia Fanfoni Giovanni Di Nardo Melania Evangelisti Thomas Foiadelli Alessandro Orsini Marco Del Pozzo Gianluca Terrin Umberto Raucci Pasquale Striano Pasquale Striano Pasquale Parisi |
| author_sort | Alessandro Ferretti |
| collection | DOAJ |
| description | IntroductionHypnic headache (HH) is a primary headache, and it is considered a rare condition in children. The underlying mechanisms of HH are not yet fully understood. This systematic review aims to provide a comprehensive description of the clinical features of all published cases of pediatric HH. It will also discuss the differences in headache features between children and adults, the increased diagnostic sensitivity of the new diagnostic criteria (ICHD-3), potential pathophysiological hypotheses explaining the higher incidence in adults, differential diagnoses, and therapeutic options for children.MethodsA systematic search was conducted to identify and analyze articles reporting cases of HH in patients under the age of 18. The search was performed in major medical databases including Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus, and Web of Science. The search covered the period from 1988 to April 2023. Relevant studies were screened for eligibility, and data extraction was performed using a standardized approach.ResultsSeven children with HH were included in the analysis. The mean age of onset for headache attacks was 10 ± 4.3 years (range 3–15 years). The average time from the start of headaches to diagnosis was 15.8 ± 25.0 months (range 1–60 months). Headache features in children differed from those observed in adult HH patients. Children experienced throbbing/pulsating pain, while adults reported dull/pressure-like pain. Children also had lower frequency and shorter duration of attacks compared to adults. The use of ICHD-3 criteria appeared to be more sensitive and inclusive for diagnosing HH in children compared to the previous ICHD-2 criteria. The association of headache attacks with sleep suggests that HH may be a primary disorder with a chronobiological origin. Hypothalamic dysfunction and melatonin dysregulation, which are more prevalent in older individuals, could potentially explain the higher incidence of HH in adults. Other primary headaches and secondary causes should be ruled out. Melatonin prophylactic therapy may be considered for pediatric patients.DiscussionFurther evaluation of the clinical features of HH in children is needed. The development of specific diagnostic criteria for pediatric cases could improve diagnostic rates and enhance the management of children with HH. |
| first_indexed | 2024-03-12T15:09:34Z |
| format | Article |
| id | doaj.art-bfb99679020c4a3c898282210be14cbc |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T15:09:34Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-bfb99679020c4a3c898282210be14cbc2023-08-11T23:17:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.12545671254567Pediatric hypnic headache: a systematic reviewAlessandro Ferretti0Margherita Velardi1Claudia Fanfoni2Giovanni Di Nardo3Melania Evangelisti4Thomas Foiadelli5Alessandro Orsini6Marco Del Pozzo7Gianluca Terrin8Umberto Raucci9Pasquale Striano10Pasquale Striano11Pasquale Parisi12Pediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyGeneral and Emergency Department, Bambino Gesù Children’s Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, Rome, ItalyPediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyPediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyPediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyPediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyPediatric Neurology, Pediatric University Department, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, ItalyPediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyDepartment of Mother and Child, Gynecological and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, ItalyGeneral and Emergency Department, Bambino Gesù Children’s Hospital, Istituto di Ricerca e Cura a Carattere Scientifico, Rome, ItalyPediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, ItalyDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, ItalyPediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, ItalyIntroductionHypnic headache (HH) is a primary headache, and it is considered a rare condition in children. The underlying mechanisms of HH are not yet fully understood. This systematic review aims to provide a comprehensive description of the clinical features of all published cases of pediatric HH. It will also discuss the differences in headache features between children and adults, the increased diagnostic sensitivity of the new diagnostic criteria (ICHD-3), potential pathophysiological hypotheses explaining the higher incidence in adults, differential diagnoses, and therapeutic options for children.MethodsA systematic search was conducted to identify and analyze articles reporting cases of HH in patients under the age of 18. The search was performed in major medical databases including Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus, and Web of Science. The search covered the period from 1988 to April 2023. Relevant studies were screened for eligibility, and data extraction was performed using a standardized approach.ResultsSeven children with HH were included in the analysis. The mean age of onset for headache attacks was 10 ± 4.3 years (range 3–15 years). The average time from the start of headaches to diagnosis was 15.8 ± 25.0 months (range 1–60 months). Headache features in children differed from those observed in adult HH patients. Children experienced throbbing/pulsating pain, while adults reported dull/pressure-like pain. Children also had lower frequency and shorter duration of attacks compared to adults. The use of ICHD-3 criteria appeared to be more sensitive and inclusive for diagnosing HH in children compared to the previous ICHD-2 criteria. The association of headache attacks with sleep suggests that HH may be a primary disorder with a chronobiological origin. Hypothalamic dysfunction and melatonin dysregulation, which are more prevalent in older individuals, could potentially explain the higher incidence of HH in adults. Other primary headaches and secondary causes should be ruled out. Melatonin prophylactic therapy may be considered for pediatric patients.DiscussionFurther evaluation of the clinical features of HH in children is needed. The development of specific diagnostic criteria for pediatric cases could improve diagnostic rates and enhance the management of children with HH.https://www.frontiersin.org/articles/10.3389/fneur.2023.1254567/fullhypnic headachechildsleepmelatoninsystematic reviewprimary headache |
| spellingShingle | Alessandro Ferretti Margherita Velardi Claudia Fanfoni Giovanni Di Nardo Melania Evangelisti Thomas Foiadelli Alessandro Orsini Marco Del Pozzo Gianluca Terrin Umberto Raucci Pasquale Striano Pasquale Striano Pasquale Parisi Pediatric hypnic headache: a systematic review Frontiers in Neurology hypnic headache child sleep melatonin systematic review primary headache |
| title | Pediatric hypnic headache: a systematic review |
| title_full | Pediatric hypnic headache: a systematic review |
| title_fullStr | Pediatric hypnic headache: a systematic review |
| title_full_unstemmed | Pediatric hypnic headache: a systematic review |
| title_short | Pediatric hypnic headache: a systematic review |
| title_sort | pediatric hypnic headache a systematic review |
| topic | hypnic headache child sleep melatonin systematic review primary headache |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1254567/full |
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