Clinical Characteristics and Burden of Primary Headache Disorders in South Indian Children

Researchers in Madurai, South India, published a hospital-based cross-sectional study examining 220 pediatric patients between six and fifteen years old who presented with primary headache disorders between September 2023 and August 2025.

Clinical Distribution of Pediatric Headaches

Among the 220 participants evaluated at the tertiary-care hospital, the median age was fourteen years, with females accounting for 125 cases or 56.8 percent of the group. Tension-type headache emerged as the predominant phenotype, affecting 110 children, which represents exactly 50.0 percent of the cohort. Migraine followed as the second most common diagnosis, impacting 65 participants or 29.5 percent. Chronic persistent headache accounted for 24 children, equal to 10.9 percent, while other primary headache disorders comprised 21 cases, or 9.5 percent of the total group.

Pain severity assessments utilizing the Visual Analog Scale established a mean score of 5.28 out of ten. Moderate pain was reported by 122 children, or 55.5 percent, whereas 52 participants, representing 23.6 percent, experienced severe pain. Furthermore, 163 children experienced headaches on one to fifteen days each month. Visual disturbances were documented in 49 children, making up 22.3 percent of the sample, while sensitivity to sound and nausea or vomiting also ranked as frequent associated symptoms.

Scholastic Burden and Daily Management

The clinical burden extended directly into academic performance and daily routines for the young patients. Reported scholastic difficulties affected 119 children, accounting for 54.1 percent of the hospital cohort, alongside frequent school absenteeism. To manage their symptoms, 113 children, or 51.4 percent, reported regular medication use for headache relief.

Screen exposure emerged as a prevalent lifestyle factor during clinical evaluations. However, researchers noted that digital device use functions primarily as a lifestyle characteristic requiring careful assessment during clinical reviews rather than an established causal determinant of headache severity. Comprehensive care recommendations from the study emphasize accurate symptom recognition, sleep optimization, nutritional assessments, and stress management to address the widespread functional impact observed in pediatric patients.