Headaches in children – Symptoms & causes

Overview

Headaches in children are common and usually aren’t serious. Like adults, children can develop different types of headaches, including migraines or stress-related (tension) headaches. Children can also have chronic daily headaches.

In some cases, headaches in children are caused by an infection, high levels of stress or anxiety, or minor head trauma. It’s important to pay attention to your child’s headache symptoms and consult a doctor if the headache worsens or occurs frequently.

Headaches in children usually can be treated with over-the-counter (OTC) pain medications and healthy habits such as a regular schedule for sleeping and eating.

Products & Services

Symptoms

Children get the same types of headaches adults do, but their symptoms may be a little different. For example, migraine pain in adults often lasts at least four hours — but in children, the pain may not last as long.

Differences in symptoms may make it difficult to pinpoint headache type in a child, especially in a younger child who can’t describe symptoms. In general, though, certain symptoms tend to fall more frequently into certain categories.

Migraine

Migraines can cause:

• Pulsating or throbbing head pain
• Pain that worsens with activity
• Nausea
• Vomiting
• Abdominal pain
• Extreme sensitivity to light and sound

Even infants can have migraines. A child who’s too young to tell you what’s wrong may cry or rock back and forth to indicate severe pain.

Tension-type headache

Tension-type headaches can cause:

• A pressing tightness in the muscles of the head or neck
• Mild to moderate, nonpulsating pain on both sides of the head
• Pain that’s not worsened by physical activity
• Headache that’s not accompanied by nausea or vomiting, as is often the case with migraine

Younger children may withdraw from regular play and want to sleep more. Tension-type headaches can last from 30 minutes to several days.

Cluster headache

Cluster headaches are uncommon in children under 10 years of age. They usually:

• Occur in groups of five or more episodes, ranging from one headache every other day to eight a day
• Involve sharp, stabbing pain on one side of the head that lasts less than three hours
• Are accompanied by teariness, congestion, runny nose, or restlessness or agitation

Chronic daily headache

Doctors use the phrase “chronic daily headache” (CDH) for migraines and tension-type headaches that occur more than 15 days a month. chronic daily headache (CDH) may be caused by an infection, minor head injury or taking pain medications — even nonprescription pain medications — too often.

When to see a doctor

Most headaches aren’t serious, but seek prompt medical care if your child’s headaches:

• Wake your child from sleep
• Worsen or become more frequent
• Change your child’s personality
• Follow an injury, such as a blow to the head
• Feature persistent vomiting or visual changes
• Are accompanied by fever and neck pain or stiffness

Talk to your child’s doctor if you’re worried or have questions about your child’s headaches.

Causes

A number of factors can cause your child to develop headaches. Factors include:

• Illness and infection. Common illnesses such as colds, flu, and ear and sinus infections are some of the most frequent causes of headaches in children. Very rarely, meningitis or encephalitis may cause headaches.
• Head trauma. Bumps and bruises can cause headaches. Although most head injuries are minor, seek prompt medical attention if your child falls hard on his or her head or gets hit hard in the head. Also, contact a doctor if your child’s head pain steadily worsens after a head injury.
• Emotional factors. Stress and anxiety — perhaps triggered by problems with peers, teachers or parents — can play a role in children’s headaches. Children with depression may complain of headaches, particularly if they have trouble recognizing feelings of sadness and loneliness.
• Genetic predisposition. Headaches, particularly migraines, tend to run in families.
• Certain foods and beverages. Nitrates — a food preservative found in cured meats, such as bacon, bologna and hot dogs — can trigger headaches, as can the food additive MSG. Also, too much caffeine — contained in soda, chocolates and sports drinks — can cause headaches.
• Problems in the brain. Rarely, a brain tumor or abscess or bleeding in the brain can press on areas of the brain, causing a chronic, worsening headache. Typically in these cases, however, there are other symptoms, such as visual problems, dizziness and lack of coordination.

Risk factors

Any child can develop headaches, but they’re more common in:

• Girls after they reach puberty
• Children who have a family history of headaches or migraines
• Older teens

Prevention

The following may help you prevent headaches or reduce the severity of headaches in children:

• Practice healthy behaviors. Behaviors that promote general good health also may help prevent headaches for your child. These lifestyle measures include getting plenty of sleep, staying physically active, eating healthy meals and snacks, drinking up to eight glasses of water daily, and limiting caffeine.
• Reduce stress. Stress and busy schedules may increase the frequency of headaches. Be alert for things that may cause stress in your child’s life, such as difficulty doing schoolwork or strained relationships with peers. If your child’s headaches are linked to anxiety or depression, consider talking to a counselor.

• Keep a headache diary. A diary can help you determine what causes your child’s headaches. Note when the headaches start, how long they last and what, if anything, provides relief.

  Record your child’s response to taking any headache medication. Over time, the items you note in the headache diary should help you understand your child’s symptoms so that you can take specific preventive measures.

• Avoid headache triggers. Avoid any food or drinks, such as those containing caffeine, that seem to trigger headaches. Your headache diary can help you determine what prompts your child’s headaches, so you know what to avoid.
• Follow your doctor’s plan. Your doctor may recommend preventive medication if the headaches are severe, occur daily and interfere with your child’s normal lifestyle. Certain medications taken at regular intervals — such as certain antidepressants, anti-seizure medications or beta blockers — may reduce the frequency and severity of headaches.

Headaches in children – Symptoms & causes

Overview

Headaches in children are common and usually aren’t serious. Like adults, children can develop different types of headaches, including migraines or stress-related (tension) headaches. Children can also have chronic daily headaches.

In some cases, headaches in children are caused by an infection, high levels of stress or anxiety, or minor head trauma. It’s important to pay attention to your child’s headache symptoms and consult a doctor if the headache worsens or occurs frequently.

Headaches in children usually can be treated with over-the-counter (OTC) pain medications and healthy habits such as a regular schedule for sleeping and eating.

Products & Services

Symptoms

Children get the same types of headaches adults do, but their symptoms may be a little different. For example, migraine pain in adults often lasts at least four hours — but in children, the pain may not last as long.

Differences in symptoms may make it difficult to pinpoint headache type in a child, especially in a younger child who can’t describe symptoms. In general, though, certain symptoms tend to fall more frequently into certain categories.

Migraine

Migraines can cause:

• Pulsating or throbbing head pain
• Pain that worsens with activity
• Nausea
• Vomiting
• Abdominal pain
• Extreme sensitivity to light and sound

Even infants can have migraines. A child who’s too young to tell you what’s wrong may cry or rock back and forth to indicate severe pain.

Tension-type headache

Tension-type headaches can cause:

• A pressing tightness in the muscles of the head or neck
• Mild to moderate, nonpulsating pain on both sides of the head
• Pain that’s not worsened by physical activity
• Headache that’s not accompanied by nausea or vomiting, as is often the case with migraine

Younger children may withdraw from regular play and want to sleep more. Tension-type headaches can last from 30 minutes to several days.

Cluster headache

Cluster headaches are uncommon in children under 10 years of age. They usually:

• Occur in groups of five or more episodes, ranging from one headache every other day to eight a day
• Involve sharp, stabbing pain on one side of the head that lasts less than three hours
• Are accompanied by teariness, congestion, runny nose, or restlessness or agitation

Chronic daily headache

Doctors use the phrase “chronic daily headache” (CDH) for migraines and tension-type headaches that occur more than 15 days a month. chronic daily headache (CDH) may be caused by an infection, minor head injury or taking pain medications — even nonprescription pain medications — too often.

When to see a doctor

Most headaches aren’t serious, but seek prompt medical care if your child’s headaches:

• Wake your child from sleep
• Worsen or become more frequent
• Change your child’s personality
• Follow an injury, such as a blow to the head
• Feature persistent vomiting or visual changes
• Are accompanied by fever and neck pain or stiffness

Talk to your child’s doctor if you’re worried or have questions about your child’s headaches.

Causes

A number of factors can cause your child to develop headaches. Factors include:

• Illness and infection. Common illnesses such as colds, flu, and ear and sinus infections are some of the most frequent causes of headaches in children. Very rarely, meningitis or encephalitis may cause headaches.
• Head trauma. Bumps and bruises can cause headaches. Although most head injuries are minor, seek prompt medical attention if your child falls hard on his or her head or gets hit hard in the head. Also, contact a doctor if your child’s head pain steadily worsens after a head injury.
• Emotional factors. Stress and anxiety — perhaps triggered by problems with peers, teachers or parents — can play a role in children’s headaches. Children with depression may complain of headaches, particularly if they have trouble recognizing feelings of sadness and loneliness.
• Genetic predisposition. Headaches, particularly migraines, tend to run in families.
• Certain foods and beverages. Nitrates — a food preservative found in cured meats, such as bacon, bologna and hot dogs — can trigger headaches, as can the food additive MSG. Also, too much caffeine — contained in soda, chocolates and sports drinks — can cause headaches.
• Problems in the brain. Rarely, a brain tumor or abscess or bleeding in the brain can press on areas of the brain, causing a chronic, worsening headache. Typically in these cases, however, there are other symptoms, such as visual problems, dizziness and lack of coordination.

Risk factors

Any child can develop headaches, but they’re more common in:

• Girls after they reach puberty
• Children who have a family history of headaches or migraines
• Older teens

Prevention

The following may help you prevent headaches or reduce the severity of headaches in children:

• Practice healthy behaviors. Behaviors that promote general good health also may help prevent headaches for your child. These lifestyle measures include getting plenty of sleep, staying physically active, eating healthy meals and snacks, drinking up to eight glasses of water daily, and limiting caffeine.
• Reduce stress. Stress and busy schedules may increase the frequency of headaches. Be alert for things that may cause stress in your child’s life, such as difficulty doing schoolwork or strained relationships with peers. If your child’s headaches are linked to anxiety or depression, consider talking to a counselor.

• Keep a headache diary. A diary can help you determine what causes your child’s headaches. Note when the headaches start, how long they last and what, if anything, provides relief.

  Record your child’s response to taking any headache medication. Over time, the items you note in the headache diary should help you understand your child’s symptoms so that you can take specific preventive measures.

• Avoid headache triggers. Avoid any food or drinks, such as those containing caffeine, that seem to trigger headaches. Your headache diary can help you determine what prompts your child’s headaches, so you know what to avoid.
• Follow your doctor’s plan. Your doctor may recommend preventive medication if the headaches are severe, occur daily and interfere with your child’s normal lifestyle. Certain medications taken at regular intervals — such as certain antidepressants, anti-seizure medications or beta blockers — may reduce the frequency and severity of headaches.

Migraine in children | Rassvet Clinic

Do children have headaches? Yes, it definitely hurts. Children are characterized by approximately the same types of headaches as adults. One of the most common and worrying is migraine, and let’s talk about it.

Migraine in a child can occur at any age and manifest itself in different ways. Infants do not complain of headache, but they can see its precursors, such as benign paroxysmal torticollis: head-tilting episodes that may be accompanied by vomiting and loss of body control. There are also studies showing a link between migraine without aura and colic.

Young children may have episodes during which they are less active than usual. Occasionally, vomiting occurs and the child may cry, rock in place, or hide, which may indicate a headache. In some cases, babies with migraine act as if they are dizzy: for example, they are afraid to walk.

School-age children can complain about headaches and how they feel about them. At this age, pain most often affects the forehead. Migraine pain lasts from 1 hour or more, is often accompanied by sensitivity to light and noise, there may be nausea and vomiting.

Symptoms of migraine in adolescents are similar to those in adults. It is pulsating, one-sided, accompanied by nausea or vomiting. Adolescents recognize their pain quite clearly and can pay attention to the aura, mood swings before an attack, and the gradual development of pain. A migraine attack at this age usually lasts from 4 to 72 hours.

Some children with migraine experience vision changes, tingling and numbness of the extremities, or difficulty speaking within a few minutes (5 to 60) before the onset of the headache. These neurological symptoms that precede the headache are called “aura”.

Visual aura is most common and may include flashing lights, zigzag lines or partial loss of vision (for cattle), visual “snow” or unusual phenomena: the image of an object remains in the field of view when the object itself has already been removed (palinopsia). It is important to know that a migraine aura usually occurs in front of one eye, spreads gradually, is usually flat, and has no specific colors.

Migraine is a primary headache, so we will not find changes on MRI, CT and other examination methods. In most cases, the cause of a child’s headache can be determined by obtaining a complete medical history and examination. Additional research is usually not required.

Diagnosis

In order to make a diagnosis of migraine, doctors use special diagnostic criteria that are suitable for children over 5 years of age.

A. At least five attacks of headache fulfilling criteria B to D.

B. Headache lasting 30 minutes or longer (without treatment).

C. Headache has at least one of the following characteristics:

• pain of moderate or severe intensity;
• unilateral or bilateral headache;
• throbbing or pressing pain;
• exercise intolerance, avoidance of walking or playing.

D. Headache associated with at least one of the following symptoms:

• loss of appetite, stomach discomfort or dizziness;
• sensitivity to light and sounds, as evidenced by the inability to watch TV or play on a computer, set-top box;
• Presence of nausea or vomiting during headache.

Е. Headache was not associated with other nosologies.

But in some cases, MRI examination of the brain is still worth it. What are these cases?

• Changes in the state that the neurologist finds during the examination.
• Sudden onset of headache.
• Pain is aggravated by straining, coughing, sneezing.
• Pain is worse when lying down.
• Under 6 years of age.
• No family history of headache.
• Recently had a head injury.
• Headache accompanied by fever.
• Headache that is new or progressive.

If any of these criteria are met, the doctor will order an MRI of the brain to rule out other causes of the headache.

Diagnosis – migraine. What to do?

Learn to stop an attack.

For migraine it is important to stop the attack as soon as possible. For this, ibuprofen, paracetamol or naproxen can be used in children.

It is important not to use combined analgesics and preparations containing caffeine, because their frequent use can lead to an increase in headaches. It is also necessary to abandon analgin and aspirin due to their side effects.

If these drugs do not help, you can talk to your doctor about using triptans. In Russia, children are allowed sumatriptan from the age of 18 (abroad from the age of 5). The most common side effects of triptans are jaw or chest tightness and mild drowsiness.

It is important to know that active movement, relaxing music and aromatherapy cannot help a child at the moment of an attack – these remedies will rather exacerbate the headache. It is better to invite the child to lie down in a quiet and dark place.

Learn to prevent the development of headaches.

Prevention of migraine begins with the search for triggers – stimuli that provoke the development of a headache. For each person, these incentives are different, but there are several of the most frequent ones: stress, disruption of the regimen, reduced sleep, menstruation.

Find out what triggers your child’s migraine with a headache diary. For an effective assessment of the diary, it is necessary to keep it for 3 months, noting in it when the headache began, how long it lasted, how it was stopped, what was provoked, how it started, what was accompanied. You can download the diary here, keep it on paper yourself or use applications and bots, for example, migrebot.

Non-drug methods.

Cognitive Behavioral Therapy – not only helps with anxiety and depression, which affect the frequency of headaches, but also with nervous cognitive attitudes associated with headaches (for example, “I will always have a headache”).

Mindfullness is a mindfulness training based on meditation. Helps reduce stress, improve psychological well-being and reduce headache days.

Cefaly is a transcutaneous trigeminal nerve stimulator, which is one of the main links in the development of migraine. It can help and stop a headache, and prevent it.

Medical methods.

Headache can be prevented by medication using certain anticonvulsants (topiramate, valproic acid), antidepressants (amitriptyline), and beta-blockers (propranolol). However, modern studies show that the effect of most of them is comparable to placebo. Therefore, some experts now suggest choosing cognitive-behavioral therapy and learning to live with migraine to start treatment. If these methods are not available, doctors, together with the patient, decide on the appointment of one of the drugs described above, based on the presence of concomitant diseases and side effects. For example, topiramate is contraindicated in people with urolithiasis and underweight, and amitriptyline is contraindicated in people with arrhythmias.

Effective in adults but not needed in children:

• botulinum toxin – indicated and proven effective in treating chronic migraine in adults, was as effective as saline in a study on chronic migraine in children;
• monoclonal antibodies are a good method, but not indicated for children, due to the risk of cessation of growth;
• biofeedback – in children has limited evidence-based effectiveness, in several studies comparing classical therapy and biofeedback, biofeedback clearly loses.

Migraine is an insidious disease and significantly reduces the quality of life, but timely diagnosis and rationally selected therapy will improve a child’s life and help him enjoy every new day again.

Author:

Frolova Anastasia Valentinovna
pediatric neurologist

causes, treatment and prevention — Medical Center “Healer”

During my work as a neurologist, I received several visits from children with migraine. According to statistical studies, up to 4% of children under the age of 14 suffer from this disease. This indicator can be considered not very accurate, because often pathologies such as vegetovascular dystonia, tension headache, increased intracranial pressure syndrome, and others are often hidden under the diagnosis of migraine.

In many cases, parents do not pay due attention to the child’s complaints of headaches, believing that these are just his whims or inventions. In addition, many doctors do not diagnose “migraine” in children, believing that this disease is typical only for adults. As a result, such actions ultimately lead to inadequate treatment of babies. Therefore, parents need to be very attentive to their child, notice signs of malaise in a timely manner, which would help the pediatrician to make the correct diagnosis for a small patient.

Causes of migraine in children

In many cases, the specific cause that caused a migraine in a child remains not completely determined. He may not be diagnosed with an increase in intracranial pressure or general temperature, and often there are no deviations from organs and systems. However, experts identify the following common causes of migraine in children:

• genetic predisposition. Mutations in genes can lead to the development of some forms of migraine;
• external factors. These include mental stress, stress, certain medications, food, and even excessive use of TV, computer and other gadgets;
• emotional component. Emotionally unstable children, hyperactive, easily excitable fall into this category;

What are the characteristics of migraine in children?

Among the distinguishing signs of the course of the disease in children are:

• short attack duration compared to adults;
• bilateral source of pain in the head, usually in the frontal or temporal regions. Pain in the back of the head is not typical and requires a separate study.

Migraines in children are often associated with motion sickness, dizziness, and a feeling of stuffy ears. In the vast majority of cases (up to 70%), pathology in children is manifested by such vegetative signs as excessive sweating, lacrimation, nasal and ear congestion, swelling of the face.

In adolescence, the symptoms of migraine are the same as in adults, they are:

• most often one source of headache;
• photophobia, intolerance to loud sounds;
• nausea, vomiting;
• less often – chills, temperature, feeling of drowsiness, disorientation in space.

Types of childhood migraines

The specific form of the disease in a child is determined by the doctor, based on the symptoms, the course of the disease, the age of the patient, the presence of a hereditary factor and any individual characteristics of the baby. Most often, the simple form (migraine without aura) and the classical form (migraine with aura) are diagnosed. Familial hemiplegic migraine is less common. This is a rare hereditary form of migraine with aura, characterized by transient paresis and paralysis, which is characterized by loss of sensation in the limbs, visual and speech disorders. Over time, these symptoms of the disease may remain unchanged or, when the patient moves into the category of adults, transform into a simple migraine.

First aid for a child with a migraine attack

The most important thing in this case is to keep the baby calm. We must try to calm him down, eliminate external irritants (bright light, noise), take care of the flow of fresh air into the room. Then you can give him to drink some non-carbonated water or juice. Overfeeding during an attack is not recommended. As a rule, a simple migraine attack in a child goes away on its own. In the future, for the selection of individual therapy, you should contact a pediatrician or a pediatric neurologist. Independently from a headache, a child can be given analgesics such as paracetamol or ibuprofen in strict adherence to the dosage according to the instructions for the drug.

Disease prevention

Above all, parents need to pay more attention to their child’s lifestyle, even if he has had at least one migraine attack. It is necessary to take measures to ensure that the child observes the regimen of the day and nutrition, to minimize the emotional and physical stress of the baby in order to prevent overload. Try to get your child to spend more time outdoors, to be physically active, to spend as little time as possible in front of the TV screen, smartphone and computer.

Be sure to seek medical attention if your child:

• has migraine attacks more than 3 times a month;
• the disease has a marked negative effect on his daily activities;
• attacks of the disease become more severe and longer;
• comorbidities, for example – obesity, sleep defects, seizures, anxiety-depressive disorder, attention deficit hyperactivity disorder.

Kabardiev Alimkhan Arslanovich, pediatric neurologist at the “Healer” medical clinic in Khasavyurt.