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Medical Diagnosis

What does your headache look like?

That is the question that University of Wisconsin pediatric neurologist Carl Stafstrom, M.D., Ph.D., has been asking children for almost 10 years.

Based on the results of his decade-long study being published in the March 2002 edition of the medical journal Pediatrics, Stafstrom says that children's drawings can help doctors diagnose and plan treatment for children's headaches.

In his study, "The Usefulness of Children's Drawings in the Diagnosis of Headache," Stafstrom found drawings to be an effective way to differentiate migraine from tension headaches in children. In 226 children who had complained of headaches, drawings were about 90 percent accurate in predicting the correct diagnosis.

Stafstrom conducted his research by giving children paper and pencils to keep them busy while he conferred with their parents. He asked each child to draw a picture of his or her headache.

"Over time," Stafstrom says, "I was amazed by the elaborate detail and insight that headache drawings were taking on," he said. "A picture is worth a thousand words."

As it turned out, artistic diagnoses correctly identified migraine headaches 87 percent of the time and non-migraine, or tension headaches 91 percent of the time.

Children suffering from migraines typically drew pictures that showed objects hitting the head, such as hammers, baseball bats, high-heeled shoes, bottles or rocks. By comparison, children who experienced the more common tension headaches drew pictures that showed a squeezing pain, such as a tight rope or band wrapped around the head.

Because the treatment for migraine and tension headaches are substantially different, Stafstrom's findings could be incredibly valuable, especially in the case of young children who cannot articulate their symptoms.

"This is a relatively simple approach that pediatricians can use in their offices," he said.