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Children often experience headaches, which manifest as pain in their head or facial region. Headaches are a common occurrence in children and are typically not a cause for concern. Similar to adults, children can experience various types of headaches, such as migraines or tension headaches related to stress. Additionally, some children may suffer from chronic daily headaches.
Headaches in children can sometimes be caused by factors such as infections, high levels of stress or anxiety, lifestyle factors, or minor head injuries. It is essential to carefully monitor these symptoms, especially if they intensify or become more frequent.
Headaches in children often resolve more swiftly than in adults. Treatment options for children’s headaches typically include over–the–counter (OTC) pain relievers and the establishment of healthy routines, such as maintaining regular eating and sleeping schedules.
Symptoms
The symptoms of headaches in children vary depending on the type of headache and can be different than those of adults. It may be challenging to identify a child’s specific headache type due to differences in symptoms, particularly in younger children who are unable to express their symptoms.
Generally, certain symptoms often align more commonly with specific categories of headache.
- Migraine:
- Pulsating or throbbing pain
- Nausea and vomiting
- Abdominal pain
- Pain that intensifies with physical exertion
- Severe sensitivity to sound and light
Migraines can occur in infants and children. When a child is in severe pain but is too young to communicate it, they may sob or rock back and forth.
- Tension–type headache: The duration of tension–type headaches ranges from a thirty minutes to several days. Younger kids might stop participating in routine play and prefer to sleep more.
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- Non–pulsating mild to moderate pain on both sides of the head
- A sensation of tightness or pressure in the muscles of the head or neck
- Absence of accompanying nausea or vomiting, which is often associated with migraines
- Pain that does not intensify with physical activity
- Cluster headache: Children under the age of 10 rarely experience cluster headaches. It usually occurs in sets of five or more episodes, with the frequency of headaches varying from one every other day to eight a day. Other signs and symptoms commonly include:
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- Involve less than three hours of sharp, stabbing pain on one side of the head
- Restlessness or agitation
- Teariness
- Congestion
- Runny nose
- Chronic daily headache: Chronic daily headaches (CDH) can be brought on by an infection, a small head injury, or overusing painkillers, including over–the–counter ones. Migraines and tension–type headaches that happen more than 15 days a month are referred to as “chronic daily headache.”
If any of the signs and symptoms persist or are noticed in children, it’s advisable to seek guidance from a healthcare provider for a thorough diagnosis. While most headaches in children are generally not a cause for significant concern, it’s crucial to stay vigilant for specific warning signals.
- Urgent medical assistance may be necessary in cases when there is a sudden worsening or increased frequency of headaches, a headache that awakens the child from sleep, headaches that follow an injury, such as a blow to the head, persistent vomiting or visual disturbances accompanying the headaches, or if the headaches are accompanied by fever and neck pain or stiffness and also if there is a change in the personality of the child.
Causes
Children’s headaches can have a variety of causes. They include, but are not limited to:
- Illness and infection: Basic medical conditions like the flu, colds, sinus infections, and ear infections, may be associated with headaches. However, it’s worth noting that meningitis and encephalitis, though possible, very rarely result in headaches.
- Genetic predisposition: Headaches, especially migraines, often have a genetic predisposition.
- Head injuries: Headaches can be a result of bumps and bruises. If a child experiences a significant head impact or their head pain worsens after an injury, it is important to seek immediate medical attention.
- Emotional factors: Headaches are a common complaint among depressed children, especially if they have difficulty identifying their emotions of sadness and loneliness. Kids can get headaches because they are stressed or anxious. This can happen when they have issues with friends, teachers, or their parents.
- Certain foods and beverages: Excessive caffeine intake found in beverages like soda, chocolates, and sports drinks has the potential to trigger headaches. The food additive MSG and nitrates, a type of food preservative commonly present in cured meats like bacon, bologna, and hot dogs, can trigger headaches.
- Brain–related issues: Persistent headaches that get worse with time, including vision issues, lightheadedness, and loss of coordination are among the symptoms brought on by pressure on certain parts of the brain due to brain tumor, abscess, or hemorrhage.
Risk factors
Children frequently have headaches. However, majority of the cases of headaches in children occur among:
- Older teenagers
- Girls, following the puberty years
- Kids with a family history of migraines or headaches
20% of kids between the ages of 5 and 17 have admitted to having headaches. Tension headaches and migraines, which are the most prevalent types of headaches in this age group, are both recorded.
Diagnosis
The diagnosis of headaches in children requires thorough assessment of the symptoms, conduct of physical and neurological exam, and requests of several tests, if necessary. No more testing is typically required if the child is otherwise healthy, and headaches are the only symptom.
- Headache history: A headache journal may be recommended to record necessary information regarding the child’s headaches, including frequency, pain intensity, and potential triggers. Detailed description of the headaches must be provided so they can be evaluated for a pattern or a common cause.
- Physical and neurological exam: The healthcare provider will assess if the movement is normal and if there are any issues with coordination or sensation. They will also do a physical exam, which involves measuring the child’s height, weight, head size, and checking their blood pressure and pulse. They will also look at the child’s eyes, neck, head, and back.
Tests can occasionally assist in determining a diagnosis or in ruling out further medical conditions that might be the source of the headaches.
- Magnetic resonance imaging (MRI): Comprehensive images of the brain are obtained using a large magnet, radio waves and a computer. The blood vessels that supply the brain can be examined using an MRI. MRI scans are typically used to identify tumors, strokes, aneurysms, neurological conditions, and other abnormalities of the brain.
- Computerized tomography (CT) scan: This aids in the diagnosis of tumors, infections, and other conditions that might result in headaches. A sequence of computer–directed X–rays are used in this imaging process to produce a cross–sectional image of the child’s brain.
- Spinal tap (lumbar puncture): This involves using a thin needle to take a small sample of cerebrospinal fluid from the lower back, which will be examined in a lab for further evaluation. This may be advised if the healthcare provider has reason to believe that an underlying disease, such as bacterial or viral meningitis, is the source of the child’s headaches.
Treatment
When dealing with headaches in children, healthcare providers take various factors into account, such as the child’s age, the type and frequency of the headaches, and the underlying cause. The goal is to customize treatment approaches to meet the child’s specific requirements, ensuring effective management and relief from their headaches.
There are four primary approaches to treating these headaches: medication, providing headache education, implementing lifestyle adjustments, and teaching stress management techniques. Most of the time, the child’s headache may be cured at home with relaxation, reduced noise, lots of liquids, healthy foods, and over the counter painkillers.
- Medications
- Over the counter pain relievers: These medications are ideally taken as soon as a headache starts. Common OTC medications to help relieve headache symptoms, including pain, nausea and vomiting are acetaminophen or ibuprofen.
Refrain from giving aspirin to children or teens recovering from chickenpox or flu–like symptoms, as it can lead to a rare but serious condition called Reye’s syndrome.
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- Prescription medications: Abortive drugs help avoid migraine symptoms like pain, nausea, and light sensitivity by interrupting the headache process. These prescription medications include long–acting triptans like frovatriptan and short–acting triptans like sumatriptan. Triptans are efficient and safe for usage in kids over the age of six. Anti–nausea medications may be prescribed for migraines with accompanying nausea and vomiting symptoms.
Caution: Taking medications should have prior discussion with a healthcare provider. It is important to take note that all medicines have negative side effects. Painkillers and other drugs may become less effective with time. Taking too much medicine can make headaches worse, a condition known as “medication overuse headache.”
- Therapies: Although stress and depression do not seem to be a direct cause of headaches, they can function as a trigger or exacerbate an existing headache. Several strategies aim to equip children with effective tools to manage and alleviate their headaches while promoting overall well–being.
