Headaches In Children

Headaches In Children | Types Of Headaches & How To Help Your Child

Headaches in children: Types of headaches children may have and how to treat them effectively

Incidence of recurrent headaches

Headaches in children: Headache is not uncommon for children above age 5 years and teens. Most young people have experienced some type of a headache by the time they reach High School. In fact, 4% of children experience headaches in elementary school.

Thankfully, less than 5 percent of headaches are the result of serious disease or organic problems, such as a tumor, abscess or head trauma.

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Causes of headaches

Approximately 15 % of these kids experience tension-type headaches and 5% are coping with migraines. Most headaches are benign or harmless and are due to stress, lack of sleep, viral infections and vision problems.

The common causes of recurrent headaches are

  • Tension headaches
  • Migraines
  • Cluster headache
  • Sinus headache
  • Head trauma-related headache
  • Intracranial mass-related headache
  • Benign intracranial hypertension
  • Meningeal irritation
  • Medication-overuse headache

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Causes Percentage in Burton’s Study Percentage in Lewis’ Study
Infections- Viral 39 39
Infection- Sinuses 16 9
Viral meningitis 5 9
Migraine 16 18
Tension 5
Trauma 7 1.3
Tumour 2.6
Seizure 1.3
Others 7 7

DONALD W. LEWIS, M.D., Eastern Virginia Medical School, Norfolk, Virginia Am Fam Physician. 2002 Feb 15;65(4):625-633.

Pediatr Emerg Care. 1997 Feb;13(1):1-4. Headache etiology in a pediatric emergency department. Burton LJ et al.

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Signs and symptoms

In children and teens with a headache, the history should include the following:

  • Headache onset, duration, and severity
  • Associated symptoms
  • Family history of migraines
  • Medication history
  • Factors that may have precipitated the headache (most often migraine)

Symptoms accompanying migraine headache may vary according to the migraine type present:

  • Migraine with aura
    • Visual symptoms
    • Sensory symptoms
    • Motor symptoms
    • Speech or language disturbances
    • Other cognitive effects
  • Complicated migraine
    • Focal or diffuse neurologic deficits
  • Acute confusional states (unusual)
    • Sudden onset of confusion
    • Unresponsiveness
    • Memory disturbances
    • Disorientation
    • Dysarthria

Physical examination – the doctor will look at the following:

  • Vital signs
  • Skin rashes or lesions
  • Signs of neurologic abnormalities
  • Hematomas or other signs of trauma
  • Signs of papilledema or subhyaloid hemorrhage on funduscopy
  • Intracranial hypertension, uncomplicated idiopathic epilepsy, seizures, meningeal irritation

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Investigation

Most often after a detailed history and examination, no investigations are usually needed. However, the doctor might ask for a different test based on the findings:
Blood counts, EEG, CT Scan or MRI, Sinus Xrays.

Tension headaches

A tension headache is the most common cause of a recurrent headache in children. They are usually mild and respond well to medication. There are two versions of a tension-type headache, episodic and chronic. An episodic headache can occur several times a month, while a chronic headache can occur almost every day.

The most common presentation is a band like pain or pressure that occurs around the forehead- front, sides, and top. It is precipitated by stressful situations, sleepless nights and irregular habits.

Common precipitating factors are due to emotional stress caused by:

  • Problems at home:
    • Poor parenting practices
    • Marital discord
    • Sibling rivalry
  • Others
    • Death or illness in the family
    • Friends leaving

Treatments

Treatment includes:

  • Simple relaxation
  • Massage
  • Ice pack
  • Warm shower
  • Painkillers
  • Identifying stress factors
  • Teaching stress management

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Headaches In Children was last modified: April 5th, 2017 by Dr. Rajeshree Singhania

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