How Are Headaches Treated In A Child
Treatment will depend on your childs symptoms, age, and general health. It will also depend on what type of headache your child has and how severe it is.
The goal of treatment is to stop the headache from occurring. Treatment may include:
Resting in a quiet, dark environment
Taking medicines recommended by your child’s healthcare provider
Learning how to manage stress
Staying away from foods and drinks that trigger headaches
Getting enough sleep
Making changes to your child’s diet
Migraine headaches may be treated with medicine, such as:
Abortive medicines. These prescription medicines act on specific receptors in blood vessels in the head. They can stop a headache in progress.
Rescue medicines. These are over-the-counter medicines such as acetaminophen that stop a headache.
Preventive medicines. These prescription medicines are taken daily to reduce severe migraine headaches.
In some cases, a headache may need medical attention right away. Your child may need to stay overnight in the hospital to be watched. He or she may need testing or surgery.
Talk with your childs healthcare providers about the risks, benefits, and possible side effects of all treatments.
Hemiplegic Migraine: An Unusual Type Of Migraine With Aura
Since she was 13, Terri has been experiencing migraine without aura approximately 1-2 times per month. Terri, who is now 21, also gets migraine with visual aura a few times per year and, on several occasions, has experienced migraine with a sensory aura . However, over the last 18 months, she has had five more dramatic episodes in which she experienced pronounced weakness/paralysis on one side of her body together with sensory symptoms and/or visual symptoms .
The weakness can last up to 12 hours and has led to Emergency Department visits on each occasion, with co-workers, family members, and Terri herself concerned that she could be suffering a stroke. CT scans and MRIs of her brain have been normal, ruling out a stroke. She was sent for tests of her heart and the blood vessels in her neck as well tests to determine if her blood was prone to form clots. All came back normal.
WHAT IS HEMIPLEGIC MIGRAINE?
A rare and more dramatic subtype of migraine with aura is hemiplegic migraine. This is an unusual migraine disorder that affects only a very small segment of the population. With hemiplegic migraine, the aura consists of weakness or paralysis of one side of the body occurring in association with any of the visual, sensory, or speech disturbances described above. The aura in hemiplegic migraine is more prolonged and can last anywhere from 5 minutes to 24 hours .
HOW IS HEMIPLEGIC MIGRAINE DIAGNOSED AND TREATED?
Less Common Symptoms Of Cgh
Examples of less common symptoms of CGH include:
- Swelling around the eye of the affected side
- Difficulty in swallowing
- Headache and neck pain affecting both sides of the head and neck
- Pain felt on touching the opposite side of the head or face during a severe attack of CGH, possibly due to an injury to the trigeminal nerve and/or spinal nerves in the cervical spine
Some conditions, such as migraines and tension-type headaches, share similar characteristics as CGH in terms of the location and symptoms. So, a careful evaluation is needed rule CGH in or out. It is also possible for CGH to occur with a migraine headache.
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Hypermobility Spectrum Disorders And Ehlersdanlos Syndrome
Hypermobile patients get hurt easily and have a lot of chronic body pain.29 There are many types of hypermobility, with a wide range of severity, from trivial party trick flexibility in one or two joints with no apparent consequences especially early in life all the way to full-blown genetic disorders of the connective tissue with many serious medical consequences. Theres a huge grey zone in the middle of under-diagnosed and under-treated people, who are definitely having problems but may never figure out why or what to do about it.
Hypermobility spectrum disorders are a group of conditions defined by joint hypermobility unexplained joint looseness. HSD is a bucket diagnosis for people with symptomatic hypermobility, but without a connective tissue disorder that explains it, like EhlersDanlos syndrome or Marfan syndrome. Most connective tissue disorders are relatively obvious, but EDS can easily evade diagnosis, making it a prime suspect in many cases of chronic pain
Exactly the wrong therapy If a lot of chronic body pain is caused by subtle diseases that make connective tissue fragile, consider how tragically misguided it would be to try to help by vigorously stretching their connective tissues! And yet thats exactly the point of fascial release, an extremely popular form of massage therapy. See Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties
How To Tell You’re Having A Migraine
Migraines are severely disabling, with symptoms ranging from intense head pain to nausea, vomiting, and fatigue. If you suffer from migraines, it’s helpful to know some common warning signs, so you can prepare for or try to prevent one. Watch this video for signs that a migraine might be around the corner.
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Claudication: The Pain Of Impaired Blood Flow
Sometimes an artery gets narrowed or pinched off and causes serious pain. Although simple in principle, it tends to get missed in younger people, where its a relatively rare problem, and so the suspicion falls on other things. It also gets missed because musculoskeletal is a realm of medicine where circulatory function is rarely considered at all. But it should be an easy diagnosis: claudication tends to cause a deep aching pain exclusively with exertion , which isnt how most musculoskeletal problems behave. Sometimes it is easy, like a straightforward case of a cyclist with a couple months of leg pain and weakness with exertion.26
And sometimes its not easy
A patient had sciatica-like leg pain for thirty-five years and was misdiagnosed many times until finally getting not only a definitive diagnosis but a cure.27 He had a narrowed artery . Thats it! Not even a difficult diagnosis in the end, really. There were some pretty glaring clues there that got ignored by a lot of people who should have known better.
But not only was he misdiagnosed many times over more than three decades, he was misdiagnosed fashionably: that is, each misdiagnosis neatly fit a paradigm in physical therapy . This carried on right up to and including the present day fascination with psychosocial factors and sensitization . Taylor and Kerry:
What Causes A Headache After Cervical Fusion Surgery
Severe headache is a common symptom of Dural Leak. If left untreated, a spinal fluid leak can lead to infection, brain abscess, and bleeding . During Cervical Fusion Surgery, your supporting ligaments are damaged or removed. Ligaments are thick pieces of connective tissue that connects bone to bone. They provide important stability.
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Abortive Medications For Acute Attacks
- intravenous medications: magnesium, Toradol, and anti-emetics
- oral medication: nonsteroidal anti-inflammatory drugs , Ubrelvy, and Nurtec
- selective serotonin receptor agonist
Hemiplegic migraine is caused by changes to genes. A few genes have been linked to hemiplegic migraine, including:
Genes carry the instructions for making proteins that help nerve cells communicate. Mutations in these genes affect the release of brain chemicals called neurotransmitters.
When the genes are mutated, communication between certain nerve cells is interrupted. This can lead to severe headaches and vision disturbances.
In FHM, the gene changes run in families. In SHM, the gene changes happen spontaneously.
Migraine often has triggers specific to you that can cause an attack. Keeping a diary of what you were doing or experiencing prior to each attack can help you narrow them down.
Common triggers of hemiplegic migraine attacks include:
Who Would Need A Migraine Treatment
If a person has more than 4 exhausting attacks per month and each attack lasts for more than 12 hours, he/she is a perfect candidate for the migraine preventive therapy. People in need of the preventive therapy can experience a prolonged aura or weakness and pain-relieving medications fail to work for them.
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Limb Pain May Be Unrecognized Manifestation Of Migraine
Daniel M. Keller, PhD
SANTIAGO, Chile Although limb pain is not included as a manifestation of migraine in international headache classifications, children and adults may experience recurrent limb pain as part of the migraine spectrum, a new study suggests. The four-generation study reveals a familial form of limb pain and migraine.
In the joint British-Chilean study, researchers performed a prospective clinical and pedigree analysis involving a 27-member family followed for 8 years. They defined migraine limb pain as intermittent arm or leg pain during a migraine episode, cluster headache, or cluster migraine with no other explanation but that may also occur in the absence of headache. The pedigree analysis showed an autosomal dominant inheritance pattern manifesting mainly as limb pain in children and as migraine in adults.
“It’s common in adults. It’s as common as hemiplegic migraine, and in children, one third of children will have some periodic syndrome like limb pain associated with their migraines,” Heather Angus-Leppan, MD, MSc, consultant neurologist at the Royal Free Hospital and senior lecturer at University College London, United Kingdom, and immediate past president of clinical neurosciences at the Royal Society of Medicine, told Medscape Medical News.
She presented her results here at the XXII World Congress of Neurology .
Limb Pain With Migraine Amenable to Treatment
XXII World Congress of Neurology . Abstract 180. Presented November 1, 2015.
Can A Fusion Be Performed For Cervical Stenosis
His practice is devoted exclusively to endoscopic spine surgery and he has never performed a fusion for severe cervical spinal stenosis. Using his technique, range of motion is preserved or increased and the surgery is directed to the bone pinching the nerve going to the shoulder and arm.
Headaches Due to Cervical Stenosis. Cervicogenic headaches will also tend to include tenderness near the base of the skull and at the neck along with worsening symptoms with head or neck movement. Neck pain may or may not accompany the headache.
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Spatial Summation And Why Some Body Areas Suffer More Like The Neck And Back
If five bees stung you all at once, in one small area on your back, you would probably think you had been stung by one super-bee . Two sources of pain close together will be felt as one larger painful spot, a neurological effect called spatial summation. Pain perception is low resolution, and the brain can merge pains that are up to 20cm apart.9 This might explain why some areas of the body, like the neck and back, are more prone to pain: either the brain can sum more widely spaced sources of pain in some places than others, and/or some areas simply have more to sum up, more potential sources of pain. Just recently, research showed that we have roughly the same perceptual resolution for pain everywhere in the body,10 so the spine is probably not a common trouble spot because we cast a wider summation net there. This makes it even more likely that theres just more to sum in the spine: lots and lots of tissues that often have minor problems, which get perceived as a smaller number of worse problems. This could also help to explain the chronicity of spinal pain: if you have one back pain problem that is actually coming from two nearby sources, youre going to think you have the same back pain problem until both sources are relieved, which is probably going to take longer.
Chronic Pain As A Destiny: Many Causes For Many Years
Nothings ever simple and chronic pain least of all: its usually caused by a sinister stew of factors that eat away at people for a long time. Chronic pain may be destiny with roots going back many years, even decades.49 Trying to solve it by fixing one thing like vitamin D, say may be about as feasible as trying to fix a broken engine with just one tool. It can be an impossible puzzle to even understand, let alone treat. Elisa Arnaudo:
Medically unexplained symptoms represent a major challenge for healthcare systems in industrialised countries. These symptoms are so prevalent that they are assessed in up to 50% of consultations in primary care.
Probably almost all MUS involve chronic pain, and Arnaudos post seems to be mostly about fibromyalgia. She proposes MUS patients are a stumper because of an inadequate explanatory framework of disease. In other words, were not just missing some pieces from a puzzle its that we probably dont even know what kind of puzzle were looking at.
And not necessarily such a puzzle.
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Light Noise Or Smells Trigger Or Worsen Pain
In the throes of a migraine attack, the migraine sufferer tends to seek refuge in a dark, quiet place. Bright lights and loud noises can trigger a migraine or intensify the pain. The same is true of certain odors.
“Once you’ve already got a migraine, smells can seem more intense and make it worse,” Dr. Calhoun says. “But a smell can also trigger a migraine in someone who didn’t have one before walked past the perfume counter.”
How Is The Weakness Of Migraine Treated
No standard treatment exists for hemiplegic migraine or any weakness that happens with it. Treating the migraine attack itself generally helps to relieve weakness or numbness.
Certain drugs used to treat general migraine, like triptans, are not recommended for hemiplegic migraine. Drugs that may work for hemiplegic migraine include:
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Vitamin D And Magnesium Deficiencies
There is not a single supplement or anti-inflammatory superfood that is clearly beneficial for any common kind of pain, but there are a couple nutritional deficiencies that stand out as significant, legitimate suspects in many chronic pain cases. Pain may be the only clear symptom of either one.
Vitamin D deficiency is on the firmest ground. It is probably more common than once suspected at least 1 in 20 people in the lowest estimates,32 and possibly many more.33 It can cause subtle widespread pain that may be misdiagnosed as fibromyalgia and/or chronic fatigue syndrome, including symptoms like muscle and bone aching,34 fatigue and weakness, lower pain threshold, and more acute soreness after exercise that is slower to resolve. For more information, see Vitamin D for Pain.
Magnesium deficiency is also a suspected factor in chronic pain, especially migraines.35 Some people are aware that magnesium supplementation is the specific rationale for Epsom salts: a form of getting the stuff into your body that is of very dubious value . Ironically, magnesium is known to induce cramping and severe muscular pain, so none of this biology is straightforward!
How Prevalent Are Migraines
Migraines are about three times more common in women than men, and may affect more than 12 percent of the U.S. adult population. Migraines often run in families, and can start as early as elementary school but most often in early adulthood. They often fade away later in life, but can strike at any time. The most common cause of recurring, disabling headache pain, migraines are also the most common underlying cause of disabling chronic, daily headache pain. While migraines are the No. 1 reason that patients see a neurologist, most cases are handled by primary care physicians.
Things that can make the headaches more likely to occur include:
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A Lot Of Pain Is Unexplained
A man hid a little wad of up his nose, and then lost it up there and then forgot it for almost twenty years oops! until it started causing severe headaches:
Through the years he suffered recurring sinus infections and had trouble breathing out of the right side of his nose. But he didnt connect the problems to his lost cannabis. It wasnt until 18 years later when he was struggling with headaches and had a CT scan of his brain that doctors finally discovered the petrified pot.
Doesnt get much more surprising than that! There are countless other less bizarre possibilities. The official causes of all kinds of chronic pain break down into three roughly equally large categories, plus one small other category:1
- musculoskeletal , a vague category dominated by arthritis, the rheumatic diseases, and headaches
- other , which is mostly cancer and abdominal pain plus everything else
Community Experiences Of Migraine And Weakness
Migraine.com advocates write about their experiences with migraine and the associated symptoms, including weakness. Some describe feeling weakness during the postdrome phase while others explore the symptoms of hemiplegic migraine and share a video of what it’s like for someone to have a hemiplegic migraine attack.
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Chronic Systemic Inflammation And Inflammaging
Chronic, subtle, systemic inflammation may be a factor in stubborn musculoskeletal pain . We get more inflamed as we age, a process quaintly known as inflammaging . This may be the way that some of the other things discussed here actually cause trouble, or it may be an independent phenomenon. Inflammaging correlates strongly with poor fitness and obesity, also known as metabolic syndrome, the biological precursor to diabetes and heart disease. And that, in turn is linked to chronic psychological stress, and of course biological stresses like smoking and sleep deprivation. Basically, the harder we live, the more likely inflammaging and metabolic syndrome get.
There are several other unproven but plausible reasons why inflammation escalates as we age. Each of these deserves its own discussion as yet another way that we may end up in pain, but they are also quite speculative, so for now Ill just lump them together as possible causes of inflammaging. For more thorough discussion of these possibilities, see Chronic, Subtle, Systemic Inflammation.
- the accumulation of permanent minor infections
- lasting collateral damage from past infections
- environmental pollutants
Its important to bear in mind that inflammation per se not the enemy, but rather whatever pathological cause for its excess. And note that neuro-inflammation specifically is strongly linked to chronic widespread pain.