Headaches and Migraines

Children, and adolescents especially, can suffer from painful headaches and migraines just as adults do, and they can be equally as debilitating.

Common headache types found in children are:

• Tension headaches are triggered by emotional or physical stressors, such as a tight or stiff neck and back muscles, or body tension due to anxiety, stress or pain following an injury. The pain is typically described as a dull aching or feeling of constant pressure or squeezing around the head. 
• Chronic daily headaches are nearly constant and can last weeks, or even months, in extreme cases.
• Migraine headaches are often inherited (run in the family) and are more common in girls than boys. They can be triggered by things such as stress, sleep deprivation, intense exercise, dehydration, menstruation or certain foods. Migraines can also occur randomly.

Causes

Headaches are thought to be caused by changes in the nerve endings, chemical messengers (called neurotransmitters) and blood vessels of the head and face. These changes send pain signals to the brain, resulting in a headache.

Headaches can be either primary or secondary. Primary headaches are not caused by an underlying medical condition and are very common in children. Secondary headaches are triggered by another medical condition, such as a sinus infection, head injury, infection, illness, dental problem or increased pressure inside the skull (intracranial hypertension).

Most children who experience headaches are otherwise healthy, and the headaches are usually NOT a sign of a more serious neurological problem.

Possible headache triggers include, but are not limited to:

• Genetic predisposition
• Emotional factors, such as increased stress, anxiety or depression
• Lifestyle factors, including dehydration, skipped meals or disrupted sleep schedules
• Medical factors, such as illness, infection, fever, head injury or medication side effects
• Environmental factors, including strong smells, long car rides, loud music or prolonged screen time
  
   

Symptoms

A handful of kids report experiencing physical or visual symptoms at the onset of a migraine known as an “aura.” Migraine pain is described as pounding or throbbing on one or both sides of the head. Some children also describe a stabbing or shooting eye pain during a migraine.

Migraines can cause a variety of associated symptoms, including:

• Nausea and vomiting
• Sensitivity to light, sound and smell
• Visual disturbances (seeing spots or colored lights)
• Dizziness or tingling in the limbs

Diagnosis

Diagnosing headaches and migraines in children can sometimes be difficult. A young child, for example, may not have the vocabulary to accurately describe what they are feeling other than simply saying “my head hurts.”

The more specific a child can be in describing the pain and exactly when and where they are experiencing it (front, back or the left or right side of the head), the better our chances are at pinpointing the cause.

Initial visits at our office will include a thorough review of patient history and any family history of headaches and migraines, a physical exam and blood tests. If necessary, other testing will be ordered and may include imaging, such as CT and MRI scans.

It is also important to determine if a pattern exists to your child’s headaches, such as:

• What time of day do they occur?
• How long do they last?
• Are there any identifiable triggers that set off the headaches?
• How quickly after reporting the pain is your child able to recover and return to normal activity?

Keeping a headache journal is a helpful way for you to gather this information, and it can greatly assist our child neurologists with diagnosis and treatment.

Treatment for Migraines and Headaches in Children

Usually, headaches can be treated easily at home. A child with a headache should rest in a cool, dark and quiet room. A cold washcloth or ice pack to the forehead or neck may also be soothing. Over-the-counter medicines, such as ibuprofen or acetaminophen, can provide relief.

However, if the headaches are frequent and severe, prescription medications may be more effective. Avoiding certain triggers, if any have been identified, is also a key component.

In addition, behavioral and dietary modifications (such as regular exercise, improved sleep and stress reduction) can go a long way in helping to manage the pain.

Other complementary treatments may include physical therapy, massage or acupuncture to help with head, neck and back pain. Counseling or talk therapy may also help children whose anxiety or stress levels are contributing factors.