Self-management of headaches in children and adolescents

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Kohen and Zajac report a retrospective large case series of outcomes of 144 patients (mean age 11.5 years) who were trained in self-hypnosis after failure of medications to control recurrent headache. Training in self-hypnosis, using primarily engagement in imagery and relaxation, was associated with substantial reduction in number, intensity, and duration of headaches. Although intrinsic limitations in study design preclude precise calculation of benefit of self-hypnosis, generalizability, or proof that hypnosis itself was the reason for improvement, the report enlightens hypotheses to be tested subsequently. It also points out the large investment of patients and healthcare systems in evaluations and medications for children and adolescents with headaches – each intervention with measurable risk and cost, and frequently without measurable benefit.