Birte Tornøe Birte Tornøe

[110] An XK, Lu CX, Ma QL, et al. Association of MTHFR C677T polymorphism with suscep‐ tibility to migraine in the Chinese population. Neurosci Lett 2013; 549: 78–81.

[111] Menon S, Cox HC, Kuwahata M, et al. Association of a notch 3 gene polymorphism

[112] Tikka‐Klemola P, Kaunisto MA, Hamalainen E, et al. Genetic association study of endothelin‐1 and its receptors EDNRA and EDNRB in migraine with aura. Cephalalgia

[113] Joshi G, Pradhan S, Mittal B. Vascular gene polymorphisms (EDNRA ‐231 G>A and

[114] Lemos C, Neto JL, Pereira‐Monteiro J, et al. A role for endothelin receptor type a in migraine without aura susceptibility? A study in portuguese patients. Eur J Neurol

[115] Tzourio C, El AmraniM, Poirier O, et al. Association between migraine and endothelin type a receptor (ETA ‐231 A/G) gene polymorphism. Neurology 2011; 56: 1273–1277.

[116] Colson N, Fernandez F, Griffiths L. Genetics of menstrual migraine: the molecular evi‐

[117] Colson NJ, Lea RA, Quinlan S, et al. The estrogen receptor 1 G594A polymorphism is associated with migraine susceptibility in two independent case/control groups.

[118] Oterino A, Pascual J, Ruiz de Alegria C, et al. Association of migraine and ESR1 G325C

[119] Oterino A, Toriello M, Cayón A, et al. Multilocus analyses reveal involvement of the

[120] Joshi G, Pradhan S, Mittal B. Role of the oestrogen receptor (ESR1 PvuII and ESR1 325 C‐>G) and progesterone receptor (PROGINS) polymorphisms in genetic susceptibility

[121] Rainero I, Grimaldi LM, Salani G, et al. Association between the tumor necrosis fac‐ tor‐alpha ‐308 G/A gene polymorphism and migraine. Neurology 2004; 62: 141–143.

[122] Mazaheri S, Hajilooi M, Rafiei A. The G‐308A promoter variant of the tumor necro‐ sis factor‐alpha gene is associated with migraine without aura. J Neurol 2006; 253:

[123] Anttila V, Stefansson H, Kallela M, International Headache Genetics Consortium, et al. Genome‐wide association study of migraine implicates a common susceptibility vari‐

[124] Kang DC, Su ZZ, Sarkar D, et al. Cloning and characterization of HIV‐1‐inducible

ESR1, ESR2 and FSHR genes in migraine. Headache 2008; 48: 1438–1450.

to migraine in a North Indian population. Cephalalgia 2010; 30: 311–320.

APOE HhaI) and risk for migraine. DNA Cell Biol 2011; 30: 577–584.

with migraine susceptibility. Cephalalgia 2010; 31: 264–270.

dence. Curr Pain Headache Rep 2010;14: 389–395.

polymorphism. Neuroreport 2006; 17: 61–64.

ant on 8q22.1. Nat Genet 2010; 42: 869–873.

astrocyte elevated gene‐1, AEG‐1. Gene 2005; 353: 8–15.

Neurogenetics 2004; 5: 129–133.

2009; 29: 1224–1231.

24 Current Perspectives on Less-known Aspects of Headache

2011; 18: 649–655.

1589–1593.

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/64971

#### **Abstract**

**Background**: Children and adolescents with frequent and chronic primary headaches are, with a prevalence of 2–23% depending on diagnosis, age, sex and frequency, a global health concern. Research on non‐pharmacological treatment outcomes is sparse. Headache service faces a challenge because possible sensitisation of pain pathways can affect outcomes leading to a delay in becoming symptom free or being cured.

**Method**: This chapter provides a narrative review of research containing suggestions for relevant focus areas for professionals who work with children and their parents in the process of self‐care.

**Conclusions**: Research supports that increased pericranial tenderness in children with consistent primary tension‐type headache is a consequence of activated pain pathways and relevant for clinical assessment. Tension patterns, posture, muscle balance and strength in the neck/shoulder region are areas of importance for minimising the triggering of input to the nociceptive system. Lifestyle factors such as sleep, nutrition, stress and tension regulation, posture and ergonomics, physical activity (PA) and exercise are a key part of non‐pharmacological team service. Empowering patient education that provides children and adolescents with the knowledge and drive to persistently pursue healthy lifestyle changes is the basis for potentially successful outcomes in terms of ethical, cultural and educational issues.

**Keywords:** children, headache service, empowering patient education, stress and ten‐ sion regulation, aerobic power

© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
