Orbitofrontal dysfunction and medication overuse in patients with migraine

Objective.—To investigate the prevalence of medication overuse headache (MOH) in a group of children and adolescents seen for headache in a third-level center in Italy. Background.—Epidemiological studies indicate a prevalence of MOH in children and adolescents between 0.3 and 0.5%; no data are available for the Italian population. Methods.—We studied a group of first-seen children and adolescents (118 patients, 43.2% male and 56.8% female, mean age: 11.9 years). A detailed history was taken, using criteria defined by Olesen et al to assess the presence of MOH. Statistical correlations between demographic and diagnostic variables were assessed. Results.—Eleven (9.3%) of our patients presented MOH; in the group with chronic daily headache, the prevalence raised to 20.8%. At follow up, after introduction of a more rationale treatment, most patients improved, but 2 of them reported a worsening of their headache. Conclusions.—We believe that a strong warning regarding medication overuse in headache therapy is essential for pediatricians and neuropsychiatrists. Key words: medication overuse headache, chronic daily headache, child, adolescence, prevalence Abbreviations: CDH chronic daily headache, ICHD-II International Classification of Headache Disorders – 2nd Edition, MOH medication overuse headache