Pediatric Neurological Disorders

Pediatric Headache

Change in Frequency of Headache Medications (N = 150)

Treatment Dates: January 2015 – December 2017

Among 150 pediatric patients treated for headache for whom adequate data was available, 65.3% showed improvement in the frequency of headache medication doses used. Improvement was defined as at least one-half standard deviation decrease in headache medication frequency in patients who were on medication at initial assessment. Median duration of follow-up was 202 days (range, 25–903).

Change in Frequency of School Days Missed (N = 43)

Treatment Dates: January 2015 – December 2017

Among 43 pediatric patients treated for headache for whom adequate data was available, 62.8% showed improvement in the number of school days missed. Improvement was defined as at least one-half standard deviation decrease in school days missed in patients with school absences at initial assessment. Median duration of follow-up was 287 days (range, 6–846).

Change in Headache Disability

2015 – 2017

PedMIDAS = Pediatric Migraine Disability Assessment

From 2015 to 2017, 144 patients with at least 2 visits had child-reported Pediatric Migraine Disability Assessment (PedMIDAS) scores available for analysis. Scores before and after treatment were 49.94 (SD = 75.28) and 29 (SD = 46.1), respectively, for an average change of -20.94 (SD = 69.09). Among the 43 patients with a baseline PedMIDAS child score ≥ 38, 67.4% showed improvement, 30.2% remained stable, and 2.3% worsened. Median duration of follow-up was 189 days (range, 91–822). Change was defined as a 38-point change in score.

From 2015 to 2017, 216 patients with at least 2 visits had parent-reported PedMIDAS scores available for analysis. Scores before and after treatment were 45.31 (SD = 64.07) and 24.75 (SD = 37.16), respectively, for an average change of -20.56 (SD = 59.09). Among the 75 patients with a baseline PedMIDAS parent score ≥ 38, 58.7% showed improvement, 33.3% remained stable, and 8% worsened. Median duration of follow-up was 223 days (range, 6–903). Change was defined as a 38-point change in score.

Change in Quality of Life After Treatment for Headache (Parent-Reported)

Treatment Dates: January 2015 – December 2017

Among pediatric patients treated for headache, approximately 35% to 45% showed improvement in quality of life compared with their initial visit, as measured with the parent version of Pediatric Quality of Life Inventory™ (PedsQL™). The PedsQL is a 0 to 100 scale with higher scores indicating greater health-related quality of life. Clinically meaningful change was defined as one-half a standard deviation of the initial scores.¹ The median duration of follow-up was 224 days (range, 6–985).

Change in Quality of Life After Treatment for Headache (Child-Reported)

Treatment Dates: January 2015 – December 2017

Among pediatric patients treated for headache, approximately 40% to 50% showed improvement in quality of life compared with their initial visit, as measured with the child version of PedsQL. Clinically meaningful change was defined as one-half a standard deviation of the initial scores.¹ The median duration of follow-up was 224 days (range, 11–974).

References
  1. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care. 2003 May;41(5):582-592.