Exertional headache - A survey of 1963 adolescents

We employed a self-administered questionnaire to investigate exertional headache (EH) in students (ages 13-15 years) from two middle schools in Taiwan. In this study, the diagnosis of EH was made if the headache occurred during or immediately after exercise. In total, 1963 students completed the study (response rate 90.7%). The prevalence of EH was 30.4% (n = 596), was higher in girls and decreased with age. EHs were commonly bilateral (51.4%), pulsating (59.4%) and short-lasting (≤ 1 h in 79%). Only 13.8% of the adolescents with EH took painkillers for the headache. Migraineurs were more likely to have EH than non-migraineurs (47.5% vs. 21.1%, P < 0.001) and their EH had more features of migraine and needed more frequent treatment with painkillers. Only 200 subjects (10.2%) fulfilled the International Classification of Headache Disorders, 2nd edn criteria for primary EH excluding criterion C. Our study disclosed that EH was quite prevalent in adolescents. Migraineurs were vulnerable to EH and had more disabling attacks.