Headaches in children
By Carleene Grant-Davis
Headaches are one of the most common recurring pain symptoms that paediatricians see. At one time or another, almost all children complain of a headache.
The most important thing about headaches in children is that most cases are not a serious cause for concern and are not even related to any of the structures in the head! Headaches are most often a symptom of other medical or emotional problems. Your child may be feeling stress and tension. However, in some cases headaches can mean more serious conditions requiring a doctor's attention.
Check allergies and sinus infections
Headaches often accompany illnesses such as a cold, flu, sore throat, allergies, sinus infections and urinary-tract infections. Other common causes include
extreme hunger or thirst, not enough sleep, specific foods and beverages: chocolate, pizza, yoghurt, nuts, processed meats, some fruits and fruit juices; food additives (monosodium glutamate, nitrates, nitrites); certain dietary supplements and medications (birth-control pills, tetracycline, excessive doses of vitamin A); foods containing caffeine (sodas, coffee, chocolate); alcohol, cocaine and other illicit substances; eye strain, including sun glare; fatigue; tooth infections or abscesses; hormonal changes during the menstrual cycle; weather changes; emotional stress, depression, anxiety, intense anger, extreme excitement; noisy, hot, stuffy environments; flickering or glaring lights; strong aromas; clenching or grinding teeth; physical exertion and head injury
Types of Headaches
The most common headaches are tension-type headaches. Tension-type headaches often feel like a tight squeezing or pressing band around the head. The pain is dull and achy and is usually felt on both sides of the head, but may be in front and back as well. There is usually no associated nausea or vomiting.
Some children experience a recurrent headache called migraine, which can begin in childhood. Migraines are very painful episodes of headache, often lasting for hours up to two days. It may feel like the inside of the head is throbbing or pounding. Migraines are usually felt on only one side of the head, but may be felt across the forehead.
Unlike tension headaches, migraines are often accompanied by other symptoms such as light-headedness, dizziness, vomiting or upset stomach. Sometimes, the child may see spots or be sensitive to light, sounds, and smells. Migraines tend to run in families.
For most types of headaches, rest and some pain medication like acetaminophen on nonsteroidal anti-inflammatory drugs may be all that is necessary, along with treatment of the primary disorder.
When is there cause for concern?
Your child should be seen by a doctor immediately if the headache is associated with any of the following:
Head injury, seizures, recurrent vomiting, dizziness and impaired balance, difficulties with vision, weakness, occurring more than once a week and persisting throughout the day; waking the child from sleep or occurring early in the morning.
Other symptoms: fever, vomiting, neck stiffness, jaw pain, toothache, any behavioural change, change in school performance or handwriting, sudden, severe onset.
Dr Carleene Grant-Davis is a consultant paediatrician and head, Dept of Paediatrics, Cornwall Regional Hospital; email: firstname.lastname@example.org