Abstract
Associate Professor Bo Bille died on the 5th January, 81 years old. For a long period of time until his death he was a member of the editorial board of Cephalalgia.
As a young paediatrician in the 1950s he was encouraged and inspired by Professor Bo Vahlquist in Uppsala, who had investigated recurrent headaches among children and early onset migraine in preschoolers, to study migraine in school children. Bo Bille used to point out that at that time very little was known and written about recurrent childhood headaches – the subject was almost neglected in the main paediatric textbooks. He started his pioneering study on migraine and nonmigrainous headaches among school children in Uppsala in 1955 and published his thesis in 1962. He first surveyed school children by means of questionnaires and almost all parents participated (99.3%). The study examined prevalence rates of frequent and infrequent migraine as well as nonmigrainous headaches in the normal population of school-aged children. These figures have been repeatedly confirmed in subsequent studies during the following decades also using other criteria for headache diagnoses. In addition, psychological functioning in migraine sufferers was compared to headache-free children, at that time this was one of the first controlled studies in the field. Bille also conducted a 6-year follow-up study of children with frequent migraine or nonmigrainous headaches. By now, the outcomes of his thesis have been cited in numerous papers on various aspects of children's recurrent headaches.
After his thesis work Bille continued to follow his original sample suffering from pronounced migraine for 40 years. His last follow-up study published in Cephalalgia 1997 included all 73 subjects except for two who had died. This achievement was possible only because his personal commitment to research made it possible to trace all his subjects over the years. He personally conducted his follow-up interviews by telephone or visits paid to his subjects when necessary. When Bille retired he encouraged one of us (BL) to move into the study of heritability of headaches, an area that Bille considered highly important. In collaboration with one of the largest twin registries in the world, the Swedish Twin registry, studies of the heritability of recurrent headaches in adults were published. The last study with Bille as coauthor was published in 1999 in this journal.
Professor Bo Bille
In Sweden Bo Bille lectured extensively on children's headaches and used TV and radio to spread and popularize his great knowledge of the field to the public. He was a consultant for the Swedish patient organization on childhood headaches. For this organization he participated in educational video programmes and also lectured in many parts of the country until he was almost 80 years old. Besides Bille's interest in paediatric headaches he was for many years the head of the children's rehabilitation department at the paediatric university clinic in Uppsala.
Together with Judith Hockaday he formed the IHS paediatric subcommittee, where he later became an honorary member because of his pioneering work. He also suggested and managed to realize special meetings on children's headaches, the first international symposium being held in Pavia, Italy, 1998. Still in 1999, at the age of 80, he planned to attend the fourth symposium held in Turku, Finland, but his health did not allow him to be present at the meeting.
Bille was a strong spokesman for developing special interest and knowledge in the field of paediatric headaches as opposed to seeing these problems as extensions from adults to ‘small adults’. In his own research Bille also emphasized important differences between adults and children in headache characteristics, one of them being the shorter duration of migraine attacks.
Bo Bille integrated research innovations and clinical knowledge in a very fruitful way. In his work he was a meticulous and conscientious person, also characterized by good clinical common sense. As a person he was always very helpful, kind and supportive in his modest and humorous ways, never hogging the limelight. For members of the IHS paediatric subcommittee, Bille was truly one of the founding fathers in the field of paediatric headaches. Following his pioneering work, today this area has developed to become acknowledged as an important health area in its own right with considerable progress achieved in the assessment and treatment of recurrent headaches in children and adolescents.