Nonmigraine headaches in adolescents.

Most adolescent headaches are related either to an acute sensory systemic illness on an acute basis or to episodic tension in a more chronic recurrent pattern. A careful history and physical and neurologic examination of these adolescents with nonmigraine headache are necessary to discern the need for additional testing. Additional testing will determine if the headaches are symptomatic of a progressive neurologic disorder or a chronic recurrent process such as tension-type headache. Only after a correct diagnosis is made can a therapeutic regimen be applied or, in the uncommon occurrence of a secondary neurologic process, appropriate diagnosis and referral to minimize morbidity be made. The important distinction for the clinician is determination of headache as a symptom of another illness or a primary chronic headache disorder.