Pandemic Lockdowns, a Novel Headache Therapy? An Audit of a Pediatric Headache Clinic in a Tertiary Center and Effects of the COVID-19 Pandemic.

BACKGROUND: The effects of stress as a major headache trigger have been well described in all populations. We sought to perform an audit of the Paediatric Headache Clinic in our tertiary center, to gain insight into the role of various demographic and lifestyle factors, as well as the impact of the COVID-19 pandemic, on headache diagnosis and response to treatment. METHODS: We conducted a retrospective cohort study on the 667 patients who presented to the pediatric headache clinic at our center. This group was divided into the prepandemic and pandemic cohorts. Diagnoses were made using the International Classification of Headache Disorders criteria. RESULTS: There were 433 patients in the prepandemic cohort and 234 in the Pandemic cohort. There were no significant differences in headache diagnoses between groups. Children who presented before the pandemic were more likely to report no response to treatment (14% vs 5%, P = 0.022). Patients in the pandemic cohort were more likely to be obese than the prepandemic (11% vs 6%, P = 0.029), but there was no significant difference in other measured comorbidities. CONCLUSIONS: We found significant differences in response to treatment and obesity rates in patients presenting to clinic before and after the onset of the COVID-19 pandemic. This may suggest that removing the stress of school had a positive effect on some headache sufferers, while reduced physical activity levels contributed to excessive weight gain. More studies examining the impact of lifestyle factors on children with headache disorders during periods of societal crisis are warranted.