Sarwer Jameel Siddiqui, Syed Muhammad Salman Shamim, Ahmed Mustafa Hashmi.
Prevalence and patterns of headache in school children in Karachi.
J Pak Med Assoc Jan ;56(5):215-7.

Objective: To determine the prevalence of headache, its different patterns and associated symptoms in school children. Methods: A population based, cross-sectional, questionnaire study, followed by interviews of selected cases and their opthalmoscopic examination was conducted in eight secondary schools from different parts of Karachi to cover all socioeconomic groups. A total of 1211 school children aged 12 to 20 years, were included. The main outcome measures studied were, prevalence of headache, associated symptoms and impact of positive family history. Results: The estimated prevalence rate of headache in school children was 85.5%. Of them 43.1% had mild, 46.6% had moderate and 8.8% had severe headache. Nearly half of them (49.6%) had a frequency of 3 or less episodes per month. Majority (58.7%) had no warning symptoms. The most common symptom prior to headache was subjective weakness (19.0%) followed by sensitivity to light (11.5%). The most common site was frontal headache (30.4%) and in 66.7% of the cases it was aching in character. Complaint of noise and light intolerance during headache was reported by 38.2%, 17.1% sought medical advice and only 0.4% needed hospitalization ever. Of those taking medicines (n =424 (41%) majority (82.3%) were self medicated. A positive family history was present in 52.5% children. All selected study subjects were found to have normal optic discs on ophthalmoscopic examination. Conclusion: Headache is a major health problem in school children. It is inappropriately treated and there is strong impact of family history (JPMA 56:215;2006).

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