What To Do For Childs Headache
- Keep encouraging plenty of fluids to keep them hydrated. Juice can be helpful for a quicker boost of sugar/calories, especially if your kiddo hasnât eaten in awhile or missed a meal.
- Have them rest in a dark, quiet room. Put them down for a nap!
- Reduce stress â find a place where your kiddo can rest for a few minutes.
- Make sure your child has eaten recently! Offer a healthy snack.
- Put an ice pack or cold washcloth across their forehead.
Common Types Of Migraine In Children And Youth
Children can also suffer from chronic or episodic headaches, and it is important to recognize the symptoms
According to the National Headache Foundation, 20% of school-aged children from 5 to 17 are prone to headaches. Of that population, 15% will suffer from tension-type headaches, while the other 5% will be prone to migraine .
Headaches and migraine can happen to anyone, at any age, including young children. Not only that, but the intricacies and symptoms of the disorder are different in children than in adults common migraine symptoms such as nausea, vomiting, and sensitivity to light and sound are not always prevalent in child sufferers. Children, in addition, cannot always vocalize or describe in detail what they are feeling, which makes diagnosis even more difficult. These patients may go undiagnosed for years, leading into adulthood, which can take a toll on their emotional and mental well being.
The American Migraine Foundation outlines a few key differences between childrens migraine and those of adults:
- migraines in children are typically shorter in duration and occur less frequently
- the pain children experience tends to be more bilateral, such as across the forehead, rather than unilateral
- while common symptoms may not be reported, a lot can be deferred from a childs behavior, such as wanting to sleep or lay down in a dark, quiet room.
Common Migraine Without Aura
Classic Migraine With Aura
Signs And Symptoms Of Migraines
Migraines are often undiagnosed in children and adolescents. In children, the symptoms may include unexplained nausea and vomiting, abdominal pain or dizziness. Some children may experience what is called aura. Aura is a visual disturbance which usually happens after a headache. This is called a classic migraine.
Signs and symptoms of aura include:
- Dizziness, vertigo, faint feelings or fainting
- Numbness or tingling, mostly on one side of body
- Visual changes, blurring, seeing spots, lines or zigzags, blind spots and rainbows around objects
- On rare occasions, confusion, hallucinations, weakness on one side of the body and inability to speak
Before a migraine happens, you can observe changes in your childs behavior. These changes are
- Food craving
- Withdrawn attitude
Sensitivity to light, touch or smell is common as well. Motion sickness should not be ignored because this is an early warning of the predisposition to childhood migraines.
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What Causes A Headache Or Migraine
The tendency to suffer from migraines is inherited. Someone else in a childs family will suffer from them too. There can also be triggers. Some migraine sufferers can identify clear triggers. It is possible for them to prevent attacks by avoiding these, but it is rarely so straightforward.
Some people experience dietary triggers where a migraine is initiated by eating a particular food. Dietary triggers are uncommon except for caffeine and alcohol. Doctors know that migraines are not caused by eye problems, other medical conditions, or having a particular type of personality.
It is much more usual for migraines to be brought on by lifestyle triggers. These can include stress, fatigue, missed meals, sleeping in and/or any disruption to sleep, and also spending too long on a computer. Unfortunately, these are all factors that are impossible to avoid completely.
For some people, the temperature of food can trigger migraine.
What Is A Migraine Headache
Migraine is a moderate-to-severe headache that lasts from 2 to 48 hours and usually occurs two to four times per month.
Migraine, also called an acute recurrent headache, occurs in about 3% of children of preschool children, 4% to 11% of elementary school-aged children, and 8% to 15% of high school-aged children. In early childhood and before puberty, migraine is more commonly seen in boys than girls. In adolescence, migraine affects young women more than young men. As adults, women are three times more likely to have a migraine than men.
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What Is The Outlook For Children And Adolescents With Migraine
Treatment helps most children and adolescents with migraine. Fifty percent of children and adolescents report migraine improvement within 6 months after treatment. However, in about 60% of adolescents who experience their first migraine as an adolescent, the migraine may continue off and on for many years.
It should be noted that many of the medications listed in this handout have not been approved by the by the Food and Drug Administration for use in children and adolescents with headaches. This is a common practice in the field of medicine and is called off-label prescribing. It is one of the ways new and important uses are found for already approved drugs. Many times, positive findings lead to formal clinical trials of the drug for new conditions and indications.
Rehabilitation program. Some hospitals and/or other health care facilities offer inpatient headache management programs for children and adolescents ask your doctor if their facility offers such programs.
Patients typically accepted into these programs are those who have a chronic daily headache , missed an excessive amount of school, have overused over-the-counter medications, and have headache pain that is controlling their lives. The staff of such programs can include psychologists, pediatric rehabilitation specialists, occupational and physical therapists as well as access to a child psychiatrist. Stress factors are an important focus of this program not rapid changes in medications.
Things To Watch For When Your Child Has A Headache
- By Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing
Headaches are common in childhood. Most of the time, they are nothing to worry about and are caused by common minor illnesses, a mild bump to the head, lack of sleep, not getting enough food or drink, or stress. Migraines can also be seen in childhood, but with awareness and avoidance of triggers, they dont usually cause problems.
Sometimes, though, headaches are a problem and something to worry about. Here is when you should worry:
1. When a headache is accompanied by a fever and a stiff neck. Your child should be able to look up at the ceiling, touch his chin to his chest and shake his head back and forth. If he cant, you should bring him to an emergency room to be sure he doesnt have meningitis.
2. When the pain is severe and unrelenting despite acetaminophen or ibuprofen. Any bad pain anywhere deserves medical attention.
3. When a headache is accompanied by frequent or persistent vomiting, especially in the absence of other signs of illness like fever or diarrhea. It may just be a virus, and children may have vomiting after a head bump, but its worth a call to the doctor, as vomiting can be a sign of pressure on the brain.
4. When along with a headache, your child is unusually sleepy or has trouble walking, talking, or doing other normal activities. Again, it could just be a virus but you should check in with your doctor.
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What To Expect When Treatment Starts
Right away, start keeping a headache diary to help you track how well medication and therapy are working. Bring the diary to your child’s follow-up appointments so the doctor can check it and tweak the treatment program, if necessary.
If your child’s symptoms get worse or happen more often even with treatment, ask the doctor to refer you to a headache specialist.
Kids Can Experience Migraine Headaches
Children can and do get migraine headaches. The rate is estimated at 5.5%, but underdiagnosis may falsely lower the number. Think about migraine in particular if a parent has migraines, as there is a strong genetic link. Kids migraines are different than adults: the pain can be on both sides of the head and not last as long. But just like in grownups, kids can be totally incapacitated with a migraine, with profuse nausea and vomiting and the need to lie in a dark room. Its not possible to make a diagnosis after just one headache, though. Kids need to have at least two episodes to be diagnosed with migraine. Ibuprofen can be a very effective treatment once a headache hits, but dont forget about ice, which can also relieve pain and decrease inflammation. A bag of frozen peas is lightweight, and the child can position it comfortably over his or her head.
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Symptoms Of Chronic Headaches In Children
Chronic daily headache is a very worrisome and often disabling problem for children and families. As the name suggests, chronic daily headaches happen every day, and often keep happening for months or years.
Chronic headaches are usually constant. Children wake up with chronic headaches and the headache stays throughout the day, although it may get better or worse in severity during the day.
Many children with chronic headaches are also nauseous and sensitive to light. Most children and adolescents with chronic daily headache don’t have any serious medical condition that’s causing their headaches.
Do Children Get Headaches
Headaches in kids are just as possible as they are in adults. These headaches can be primary and secondary. Primary headaches â meaning they arenât caused by an underlying disease â are common. Think cluster headaches, tension headaches, and migraines. There is an endless list of conditions that cause secondary headaches, which we will not go into today.
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American Academy Of Neurology/american Headache Society
In August 2019, the American Academy of Neurology and American Headache Society issued new guidelines on preventing and treating migraine in children.
Recommendations for migraine prevention include the following:
Counsel patients and their caregivers that lifestyle factors, such as poor sleep habits and tobacco use, can contribute to headache frequency and should be modified.
Advise patients and their families that most trials of preventive medications have failed to show any benefit over placebo. A potential exception is propranolol, which may “possibly” result in a 50% reduction in headache frequency in children.
Recommendations for acute treatment include the following:
Counsel patients and their caregivers that treatment is most effective when given early in the attack. Ibuprofen oral solution should be the initial treatment for children and adolescents. Additionally, adolescents may take triptans, such as sumatriptan/naproxen tablets and zolmitriptan nasal spray.
For patients who also have substantial nausea and vomiting, offer an antiemetic.
Caution patients and their families about medication overuse. For example, ibuprofen should not be used more than 14 days a month, and triptans shouldn’t be used more than 9 days a month.
When To See A Pediatrician Or Dentist
Some discomfort is expected when your childs 6-molars are emerging. However, in some cases, your child may develop an infection.
If your child experiences a fever higher than 104°F , you should take them to a doctor. If their symptoms last longer than a week, you may also want to visit a doctor to check for complications.
Its also a good idea to bring your child to a dentist for routine checkups to check for cavities, bite problems, and to monitor potential tooth problems before they occur.
The American Academy of Pediatric Dentistry recommends that most children should visit the dentist every 6 months.
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What Ages Do Migraine Headaches Appear In Children
Although migraine headaches most commonly occur in teens and young adults, the attacks can start early in life and have been reported in about 3% of preschool-age children. Likewise, migraine headaches have been reported in babies and toddlers, and some researchers believe that colic may be a sign of migraine in newborns, or at least a warning sign of migraine attacks later in life. Migraine symptoms include nausea, vomiting and/or sensitivities to light and sound that can last for up to three days. However, these symptoms may not be as obvious or could be mistaken for other conditions when they appear in children.
Migraine Headache Care For Kids
Specialized care for migraine headaches.
Your health care provider team may order additional tests for your child if there are features of the headache that raise concerns for a different type of headache.
Reasons to seek immediate evaluation by your pediatrician or an emergency department include:
- Thunderclap headache a headache that is severe within a few minutes of its onset
- Positional headache a headache that changes significantly depending on whether you are lying down or standing up
- Headache that starts after a trauma or whiplash
- Headache that wakes you from sleep at night
- Headache associated with other symptoms, such as weight loss, fever or rash
- Headache with focal neurologic symptoms, such as weakness in the arms or legs, unsteady walking, difficulty hearing or communicating, seizure, etc.
- Changes in your thinking or speech during a headache
Migraine is often are under diagnosed in children, but it is a major cause of disability that can cause kids to miss school and activities, and can affect quality of life. Many children outgrow migraine, but about a third of children will continue to experience migraine headaches as an adult.
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Migraine Headache In Children Symptoms
A headache may be a symptom of a benign condition, or it may be a life-threatening symptom. The patient’s medical history and physical examination results are often enough to identify or rule out serious underlying problems or conditions. Testing is employed to support a suspected diagnosis.
No specific laboratory or radiological test establishes the diagnosis of migraine headache. Doctors make the diagnosis through medical history, physical examination with emphasis on the neurological components, and clinical judgment. When considering a diagnosis of migraine headache, the doctor will ask about a child’s medical history, previous tests, allergies, and current and previous medications.
- Children will be asked to describe how the headache feels .
- They will also be asked about the headache’s location, timing, severity, causal events , duration, and whether any relatives have migraine headaches.
- Other common historical evidence to support the diagnosis of migraine headache includes sensitivity to light and sound, tenderness in the scalp and a strong desire to lie down and sleep.
Conditions that cause severe headaches in children include both primary and secondary disorders.
Do Babies Get Headaches
Headaches in babies are possible. Babies who experience signs and symptoms of a headache or migraine are unable to tell you but yes, our babies can still get headaches! They may be fussier, hold their head while crying, withdraw from regular playing, feed poorly, or sleep more.
Infant migraine symptoms have been linked to babies with colic, especially when there is a history of migraines in mom or dad. Studies have shown that children who experience migraines are more likely to have had colic as a baby when compared to children who donât have migraines.
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Psychological Physiologic And Environmental Triggers
In predisposed individuals, migraine attacks can occur as a result of psychological, physiologic, or environmental triggers however, encourage the patient to maintain a relatively normal lifestyle by optimizing trigger factors and using prophylactic medications.
Psychological triggers include stress, anxiety, worry, depression, and bereavement. Emphasizing to the patient and family that migraine is not an imagined or psychological illness is important. Stress is not the sole cause of migraine, although it makes an underlying migraine predisposition more difficult to manage. The frequency of migraines can be reduced by maintaining a healthy lifestyle, but it cannot be eliminated.
Physiologic triggers include fever or illness, fasting, missing a meal, fatigue, and sleep deprivation. Encourage children with migraine attacks to maintain a routine with regular meal times and adequate sleep. Ice cream or cold is an interesting physiologic stimulus. Raskin and Knittle found that ingestion of ice cream caused headaches in 93% of their migraine patients. The headache typically was located at the usual site of migraine pain.
Environmental triggers of migraine include the following:
How Are Headaches Diagnosed
The full extent of the problem may not be completely understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a headache is made with a careful history and physical examination and diagnostic tests. During the examination, the doctor obtains a complete medical history of the child and family.
Questions commonly asked during the examination may include the following:
When do headaches occurs?
What is the location of the headache?
What do the headaches feel like?
How long do the headaches last?
Have there been changes in walking and behavior patterns, or personality?
Do changes in positioning or sitting-up cause the headache?
Is your child having trouble sleeping?
Does your child have a history of emotional stress?
Is there a history of trauma to your child’s head or face?
If the history is consistent with migraine or tension type headaches and the neurological exam is normal, no further diagnostic testing may be necessary.
Other diagnostic tests may include:
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Migraine Headache In Children Facts
- Studies suggest that migraine headaches occur in 5% to 10% of school-aged children in the United States This frequency gradually increases through adolescence and peaks at about 44 years of age. Many people experience spontaneous remission, meaning that the headaches go away on their own for no clear reason.
- The age of onset of migraine headaches is earlier in boys than in girls. From infancy to 7 years of age, boys are affected equally or slightly more than girls. The prevalence of migraines increases during the adolescent and young adult years. After menarche , a female predominance occurs. This continues to increase until middle age. The frequency of migraines declines in both sexes by 50 years of age.
- Most migraineurs begin to experience attacks before 20 years of age. Approximately 20% have their first attack before their fifth birthday. Preschool children experiencing a migraine attack usually look ill and have abdominal pain, vomiting, and a strong need to sleep. They may show pain by irritability, crying, rocking, or seeking a dark room in which to sleep.
- Migraineurs aged 5 to 10 years of age experience:
- osmophobia , and
- a need to sleep.