# Rare Primary Headaches in Children: A Narrative Review

## TL;DR

This review discusses rare primary headaches in children that are often misunderstood, leading to delayed diagnosis and treatment.

## Contribution

The paper provides an updated overview of rare pediatric primary headaches and their clinical, therapeutic, and pathophysiological aspects.

## Key findings

- Rare primary headaches in children are often misdiagnosed due to poor understanding by physicians.
- The review highlights specific headache types like cough headache and thunderclap headache that are challenging to diagnose in pediatric cases.
- These conditions can cause significant disability in children and adolescents.

## Abstract

Headache is a very common disorder in children and adolescents. While migraine and tension headaches are well-known and diagnosed by pediatricians, a group of primary headaches in children, rare in frequency, are poorly understood and likely underestimated by physicians, resulting in delayed diagnosis and treatment. This review aims to provide an updated overview of these clinical forms, considering new evidence. We will present the main clinical, therapeutic, and pathophysiological aspects and possible future hypotheses, with specific reference to pediatric cases of the following clinical forms: cough headache, thunderclap headache, cold headache, primary stabbing headache, nummular headache, hypnic headache, red ear syndrome, and non-odontogenic orofacial pain. These clinical forms currently pose a major diagnostic challenge for pediatricians and represent a source of serious disability for children and adolescents.