HEADACHE

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Last Updated : 8/1/2015
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First Author : Dr. Ira Shah
Current Author : Monica Madavariya
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How Common Are Headaches in Children and Adolescents?
Headaches are very common in children and especially adolescents. By age 15, 5% of all children and adolescents have had migraines and 15% have had
tension headaches
.

Many parents worry that their child's headache is the sign of a brain tumor or serious medical condition, but most headaches in children and adolescents are not the result of a serious illness.

What Types of Headaches Do Children and Adolescents Get?
Children get the same types of headaches adults do, including tension headaches, migraines, and sinus headaches.

What Causes Headaches in Children and Adolescents?
Most headaches in children are due to an illness, infection, cold, or fever. Other conditions that can cause headaches include sinusitis (inflammation of the sinuses), pharyngitis (inflammation or infection of the throat), or otitis (ear infection).

The exact causes of migraines are unknown, although they are related to changes in the brain as well as genetic causes.Most children and adolescents -- an estimated 70% -- who have migraines have an immediate family member who also suffers from them or who did in childhood. Children and adolescents with migraines may also inherit the tendency to be affected by certain migraine triggers, such as fatigue, bright lights, and changes in weather.

Other migraine triggers can be stress, anxiety, depression, a change in routine or sleep pattern, loud noises, or certain foods, food additives, and beverages. Too much physical activity or too much sun can trigger a migraine in some children or adolescents, as well. In girls, changes during the menstrual cycle may trigger a bad headache.
Common causes of tension headaches include striving for academic excellence as well as emotional stress related to family, school, or friends. Other causes of tension headaches include eyestrain and neck or back strain due to poor posture. Depression may also be a reason your child is having headaches.

While most headaches are benign, when headaches worsen over time and occur along with other neurological symptoms such as loss of vision, speech problems, or muscle weakness, they can be the sign of a more serious problem, such as:

Hydrocephalus (abnormal build-up of fluid in the brain)
Infection of the brain including:
Meningitis (an infection or inflammation of the membrane that covers the brain and spinal cord)
Encephalitis (inflammation of the brain)
Abscess
Hemorrhage (bleeding within the brain)
Tumor
Blood clots
Head trauma
If you suspect any of the above listed conditions, immediately take your child to his or her doctor for evaluation.

How Are Headaches Evaluated and Diagnosed in Children and Adolescents?
If your child has headache symptoms, the first step is to take your child to his or her doctor. The doctor will perform a complete physical exam and a headache evaluation. During the headache evaluation, your child's headache history and description of the headaches will be evaluated.

A headache evaluation may include a CT scan or MRI if a structural disorder of the central nervous system is suspected. Both of these tests produce cross-sectional images of the brain that can reveal abnormal areas or problems.

If your child's headache symptoms become worse or become more frequent despite treatment, ask your child's doctor for a referral to a specialist. Children should be referred to a pediatric neurologist, and adolescents should be referred to a headache specialist. Your child's doctor should be able to provide the names of headache specialists

How Are Headaches Treated in Children and Adolescents?
Treatment of headache may include education, stress management, biofeedback and medications.

Headache education includes identifying and recording what triggers your child's headache, such as lack of sleep, not eating at regular times, eating certain foods or additives, caffeine, environment, or stress. Helping your child keep a headache diary can help you and your child record this information. Avoiding headache triggers is an important step in successfully treating the headaches.
Stress management: To successfully treat tension headaches, it is important for kids and their parents to identify what causes or triggers the headaches. Then they can learn ways to cope or remove the stressful activities or events.
Biofeedback: Biofeedback equipment includes sensors connected to the body to monitor your child's involuntary physical responses to headaches, such as breathing, pulse, heart rate, temperature, muscle tension, and brain activity. By learning to recognize these physical reactions and how the body responds in stressful situations, biofeedback can help your child learn how to release and control tension that causes headaches.
Medications: There are three categories of headache medications for children, including symptomatic relief, abortive, and preventive medications. Many of the drugs used to treat adult headaches are used in smaller doses to treat headaches in children and adolescents. But aspirin should not be used to treat headaches in children under age 15. Aspirin can cause Reye's syndrome, a rare, but fatal condition, young kids can get.

What Happens After My Child Starts Headache Treatment?
When your child's doctor starts a headache treatment program, keep track of the results by using a headache diary, and record how the treatment program is working. Keep your child's scheduled follow-up appointments so your child's doctor can monitor progress and make changes in the treatment program as needed.

Do Children Outgrow Headaches?
Headaches may improve as your child gets older. The headaches may disappear and then return later in life. Many boys who have migraines outgrow them, but in girls, migraine frequency increases with age because of hormone changes. Migraines are three times more likely to occur in adolescent girls than in boys. And women are three times likelier than men to suffer from migraines.



Contributor Information and Disclosures First Author : Dr. Ira Shah
Consultant Pediatrician, B.J.Wadia Hospital for Children, Mumbai, India

Current Author : Monica Madavariya


First Created : 5/7/2001
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