Children and adolescents get the same type of headaches as adults but their symptoms are often different. The criteria that are used to categorize headaches in adults are only partially successful in children. In addition, young children or children with special needs have difficulty describing and providing information. This can make headache management difficult.
Generally, headaches in children are not serious. In most cases routine headaches are caused by minor illness, fatigue, stress or anxiety. Sleep and schedule disruption area also common factors. If the cause of the headache is not clear and the headaches continue or appear to worsen you must discuss them with your pediatrician. Although most headaches can be easily treated with time, rest and over the counter medications some of the headaches children have require advice from your pediatrician or a specialist who deals with headaches in children.
The most common types of headaches are tension type headaches and migraine headaches. Tension headaches may be intermittent or chronic and can last from 30-60 minutes to several days. The pain is usually mild to moderate in intensity and does not prevent your child from being active. Most of the time, other associated symptoms including nausea, vomiting or noise and light sensitivity do not occur. There is often a description of band like pressure around the head but this history is difficult to obtain in children. Migraine headaches are similar to tension headaches. They generally are more severe and the child often describes a pounding sensation on one or both sides of the head. Pain increases with exertion and distraction is of limited help. Vision changes, nausea, vomiting and stomach pain are common associated complaints as is sensitivity to light, noise and various smells. These children may experience a warning (aura) that a headache is coming and there often is a family history of migraine headaches.
Another type of headache is chronic daily headache. This can result from taking some types of medication and can include rebound headaches from taking excessive OTC pain medication or be caused by environmental stress related factors.
The first step with all headaches is to look for a cause and identify any patterns or triggers. Emotional factors and genetic predisposition need to be considered as do any underlying medical conditions. You must keep an accurate record of the headaches. The use of a headache diary and headache drawings will be discussed with you by your pediatrician.
This information is the most important factor in developing an effective treatment plan. The next step is to develop a holistic approach involving holistic lifestyle changes while monitoring for specific triggers or patterns that bring on a headache. Special testing including brain imaging and lab tests are frequently not needed. A thorough history, physical examination and neurological examination are the fundamental interventions.