CHILDHOOD HEADACHE

How common is headache ?

Headache is one of the most common disorders and childhood . 10% of school age children experience, recurrent headache. Headache can have a significant impact on children because of effects on day-to-day functioning, school, attendance, social and leisure activities and concentration.

What are the causes of headache ?

Migraine and tension type headache are the two most common causes of headache in children. 

Children also tend to get headaches with a cold , flu , sore throat, dental problems or a sinus infection. Other common causes include  skipping meals , not drinking enough fluids ( dehydration),sleeping less, stress and  too much of screen  time( TV /mobile/laptop)

Serious infections( meningitis) , severe high blood pressure or brain tumors are extremely rare causes of headache and usually have many other symptoms associated with headache .

What what can I expect from the consultation, when I visit my doctor with my child for headache?

Your doctor will take a detailed history of the symptoms of headache from both you and the child . They will need information about  location of maximum pain, Quality of pain eg throbbing, constant, Intensity of pain, Duration of a typical attack, Frequency of attacks any Other symptoms associated  like nausea, vomiting, sensitivity to light  and facial drooping etc.

They will perform a detailed neurological examination of the child and a full examination of the child and then suggest possible causes and may suggest some medications.

Should I get an MRI brain for my child with a headache?

MRI brain is not needed routinely for children with headache. 

Once your doctor has evaluated your child , then if there are any red flags as below , they may request MRI Brain scan.

• Headache causing waking from sleep
• Early Morning headache with vomiting
• New neurological symptoms eg new gait or co-ordination disturbance, head tilt, new squint, loss of visual acuity, or doctor finds anything abnormal on examination
• Focal seizures or fits 
• Vomiting, increasing head size  or irritability in a young child
• Deterioration in school performance (or developmental decline in a younger child)
• Growth failure
• Precocious puberty or early puberty 
• Sudden onset severe headache
• Any new neurological abnormality on examination

Is there anything I can do to make my child feel better?

You can ask your child to rest in a dark room and sleep and give some children's paracetamol and apply some balm ( provided they are not allergic) on the head.

In the next section we’ll explore specific causes like Migraine and tension type headaches .

References:

1. Global Burden of Headache Disorders in Children andAdolescents 2007–2017 ,Matilde Leonardi ,Licia Grazzi , Domenico D’Amico , Paolo Martelletti , Erika Guastafierro ,Claudia Toppo and Alberto Raggi .International Journal of Environmental Research and Public Health

2. Better Safe than tumor

Dr Rashmi Adiga

MBBS, DCH, MRCPCH(U.K), CCT(U.K), FRCPCH.

Consultant Paediatric Neurologist