Dr. Roxanne Melbourne Chambers, Contributor

Headache is a very common neurologic complaint affecting children. Research has shown that by age three, headaches would have occurred in three to eight per cent of children. This figure increases to approximately 50 per cent of seven year olds and 80 per cent of 15 year olds.

Why do headaches occur?

Head pains are caused by any condition which causes stimulation of the pain sensitive nerves supplying the head and neck. In children, isolated headaches often occur due to an obvious cause for example, fever, dental disease and sinus congestion.

When is a headache considered serious?

More serious headaches may occur due to stretch of blood vessels supplying the brain or inflammation of the covering membranes of the brain (the meninges). Serious conditions which result in stretch or irritation of these membranes include meningitis (infection of the brain and inflammation of its membranes), brain tumours or an intracranial haemorrhage. Headache symptoms in these severe conditions are listed below. The presence of any of these symptoms requires urgent medical attention.

Migraine headache in children

Children experience chronic, recurrent headaches too, a common cause of which is migraine. This is an inherited condition - in most cases there is an affected parent. Migraine is also more frequent in children with allergic conditions such as hay fever and asthma.

Migraine headaches may be unilateral or bilateral (one or two sided) and are often described as 'pounding' and severe. The child has to stop his activities and may experience nausea, dizziness or vomiting. Children may describe visual disturbances at the beginning of the headache for example, seeing coloured lights or blurring of the vision; bright light or loud noises may worsen the headache. The head pains typically last an hour or more and are relieved by pain-relieving medication (acetaminophen or ibuprofen) and by relaxation or sleep in a quiet, dark environment.

How is migraine managed?

Migraine is best managed by lifestyle modification and avoidance of conditions that precipitate the headaches. Maintaining a headache diary may help one to identify related events. Regular meals, consistent sleep patterns and routine exercise improve headache frequency.

Pain-relieving medication should be taken at the onset of the headache when they are most effective. Physicians may prescribe other specific migraine medications for severe migraine in children older than age 12. Rest in a quiet environment is also recommended.

If migraine headaches occur so frequently that the child's usual activities, for example attending school or participation in an extracurricular activity, are disrupted, the physician will often prescribe appropriate preventive medication and other forms of relaxation therapy to try to decrease the frequency and severity of the episodes.