Headache

A headache refers to pain or discomfort anywhere in the region of the head or neck. Headaches are the most common health complaints experienced by every person at some point during their life. Children also suffer from headaches but may experience slightly different symptoms. Most headaches are not serious.

Types

Like adults, children can experience different types of headaches including:

  • Migraines
  • Stress-related headaches
  • Cluster headaches
  • Chronic headaches

Symptoms

Migraines are throbbing, pulsating headaches which may be associated with nausea, vomiting, increased sensitivity to light or sound, pain with exertion or abdominal pain. Migraines in children usually last less than 4 hours while in adults they are usually more prolonged.

Tension-type headaches are non-pulsatile in nature and associated with tightness of the head and neck muscles. Pain is generally felt on both sides of the head and does not alter with activity. Pain may be present for half an hour to several days and may cause your child to be less active and sleep more often.

Cluster headaches, rarely seen in children under the age of 10, cause sharp stabbing pain on one side of the head which may be accompanied by congestion and restlessness. This is characterised by five or more headache episodes occurring over a period of 8 hours to about a week.

Headaches that occur more than 15 days in a month are termed chronic daily headaches.

Causes

Headaches in children may be associated with stress, anxiety, infection, injury, frequent use of pain medication, presence of a tumour, abscess or from certain foods. They commonly occur in girls after puberty, older teens and those with a positive family history.

Diagnosis

A headache may be difficult to identify in children who are too young to describe their symptoms. Crying while holding the head can be an indication. Your doctor will review all associated symptoms and family history and perform a physical examination focusing on your child's neurological status. Imaging studies may be ordered to help identify an underlying cause. A spinal tap may be ordered if meningitis is suspected. This involves obtaining a sample of spinal fluid from the lower back for laboratory evaluation.

Treatment

To treat a headache, your child's doctor may recommend rest, pain medications including over the counter medications or prescription medication for migraines, control of environmental factors such as light and sound and adequate fluid intake. Some children find therapies such as relaxation exercises, massage, cognitive behavioural therapy and biofeedback training useful for dealing with tension and headache triggers such as stress and depression.

aaPN&R North American Neuromodulation Society NASS American Society of Interventional Pain Physicians