Migraines and Other Headaches

Headaches, whether they are pounding and throbbing or dull and aching, affect children and teens as much as adults. It is a common medical problem, and a frequent cause of school absences. Headaches may be triggered by something as simple as taking too much caffeine, skipping a meal, staying up too late, or playing in the sun too long. At times, headaches last longer or are accompanied by other symptoms. They range in type, can have a variety of causes and different levels of severity and frequency. Certain types of headaches, like migraines, tend to run in families. It’s important to know how to recognize when a headache is just a passing pain, when it’s something more and when your child needs medical treatment.

The head pain process often starts with pain produced by the cranial nerves, blood vessels and the muscles that cover the head and neck. The muscles or blood vessels can swell, tighten, or go through other changes that stimulate or put pressure on the surrounding nerves. These nerves send a rush of pain messages to the brain, which brings on a headache. The International Classification of Headache Disorders divides headaches into two major categories — primary and secondary. Primary headaches can be hereditary and are often due to a person’s neurochemical makeup, and not the result of another health problem. Secondary headaches result from causes or conditions like head injuries, tumors, medication side effects, infections, sinus problems or fever-inducing illness such as a flu.

Examples of primary headaches include:

No one knows for sure what causes migraine headaches. Kids who get migraines usually have a family member with a history of migraines as well, suggesting that migraines can be an inherited disorder. It may be triggered or worsened with:

The best way to help decrease the frequency and severity of headaches in your children is to make sure they take good care of themselves. Making a few modifications to your child’s lifestyle can significantly reduce headache frequency. Kids should regularly get between eight and 10 hours of sleep.  Do not let your child skip meals. Low blood sugar can trigger a headache. Avoid potential food triggers such as aged cheese, chocolates, cured meats and caffeine. Keep your children active making sure they get a moderate amount of exercise. It helps to reduce stress and keeps them physically fit. Make sure kids drink plenty of water, especially during and after exercise or playing sports. Kids and teens need 32 to 64 ounces of fluid a day. Avoid activities that may provoke a migraine like prolonged playing of video games, looking at the computer screen for too long, or listening to loud music. Help your child reduce any stress in his life.

The evaluation and diagnosis of headaches start with a thorough history and, physical and neurologic examinations. Your child’s doctor may ask you or your son to keep a headache diary to help him figure out what causes the headaches. The diagnosis of a primary headache is usually based on clinical symptoms, but in some cases your child’s doctor may need to perform blood tests or use imaging tests such as CT scan or MRI, to exclude more serious medical problems.

Your child’s doctor will come up with a treatment plan based on the type, severity and frequency of your child’s headache. Analgesics, such as acetaminophen and ibuprofen, or prescription medications may be recommended to help relieve the pain. Medicine may also be prescribed to control nausea or vomiting. Never give aspirin to kids younger than 12 years old. Children and teens under age 19 should also avoid taking aspirin during an illness caused by a virus, since it has been linked to Reye’s syndrome, a potentially life-threatening condition.

Patients who have frequent headaches may be prescribed preventive medicines that will be taken daily to reduce the frequency and severity of headaches.

Lifestyle changes and stress reduction may also be needed. Another part of your child’s treatment may consist of learning biofeedback, a relaxation program that teaches your son deep breathing to control his heart rate and muscle relaxation to reduce body stress, tension and pain. Biofeedback has been proven to reduce the frequency and duration of headaches in children.

While headaches rarely indicate a life-threatening problem, you should call your child’s doctor if he experiences any of the following:

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