Whether they’re pounding and throbbing or dull and aching, headaches are no picnic for kids. A lot of the time, they’re caused by something simple - such as staying up too late, playing in the sun too long, or taking a bump to the head. But sometimes, headaches last longer or are accompanied by other symptoms.
Headaches can have a wide range of causes and many levels of severity. It’s important to understand how to recognize when a headache is just a passing pain, and when it’s something more and your child needs medical treatment.
What’s a Headache?
Most headaches happen outside the skull, in the nerves, blood vessels, and muscles that cover the head and neck. The muscles or blood vessels can swell, tighten, or go through other changes that stimulate or put pressure on the surrounding nerves. These nerves send a rush of pain messages to the brain, which brings on a headache.
What Causes Headaches?
In general, kids get the same types of headaches as adults. And headaches often are hereditary, so if you or your partner get them, your child may get them too.
Some of the many potential headache triggers include:
1. certain medications (headaches are a potential side effect of some)
2. too little sleep or sudden changes in sleep patterns
3. skipping meals
4. becoming dehydrated
5. being under a lot of stress
6. having a minor head injury
7. using the computer or watching TV for a long time
8. menstruation
9. experiencing changes in hormone levels
10. taking a long trip in a car or bus
11. listening to really loud music
12. smoking
13. smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
14. drinking or eating too much caffeine (in soda, coffee, tea, and chocolate)
15. consuming certain foods (such as alcohol, cheese, pizza, chocolate, ice cream, fatty or fried food, lunchmeats, hot dogs, yogurt, aspartame, or anything with the seasoning MSG)
16. In some cases, headaches are caused by certain infections, such as:
* ear infections
* flu
* Lyme disease
* sinus infections
* strep throat
* urinary tract infections
* But most headaches aren’t signs that something more is wrong. Only 10% of headaches are caused by other medical conditions, such as infections or other serious illnesses.
What Are the Common Types of Headaches?
Two of the more common kinds of headaches that kids get are tension headaches and migraines.
Tension Headaches
Fairly common in kids, tension headaches (also called muscle-contraction headaches) are caused by tension in the muscles of the neck and head, which can be brought on by a variety of emotional and physical stressors. The pain is often described as:
* constant pressure around the front, top, and sides of the head, almost like someone stretched a rubber band around it
constricting
* dull
* aching
* A major distinction between tension headaches and migraines is that tension headaches typically are not accompanied by nausea or vomiting, and they’re usually not made worse by physical activity - symptoms that do often occur with migraines.
Migraines
About 5% of school-age kids and up to 10% of teens get migraine headaches, recurrent headaches with additional symptoms. Often triggered by things like stress, sleep deprivation, and certain foods and beverages, migraine headaches can cause the following symptoms:
* pounding, throbbing pain on one or both sides of the head
* dizziness
* stomachaches
* nausea and/or vomiting
* seeing spots or halos
* sensitivity to light, noise, and/or smells
* Most migraines last anywhere from 30 minutes to 6 hours. Some can last as long as a couple of days. Some people:
Just don’t feel right. Light, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to perform physical activities may make the pain worse.
Get auras, a kind of warning that a migraine is on the way (usually about 10 to 30 minutes before the start of a migraine). The auras may only be seen in one eye. The most common auras include: blurred vision, seeing spots, jagged lines, or flashing lights, or smelling a certain odor.
Experience a migraine premonition hours to days prior to the actual headache. This is slightly different from auras and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.
Have muscle weakness, lose their sense of coordination, stumble, or even have trouble talking either just before or while they have a headache.
Unfortunately, parents of an infant or toddler probably won’t be able to tell if their little one is having migraines because little kids are often unable to explain or detail what hurts. Young kids with headaches may be cranky, or have symptoms of clumsiness or look pale.
There are also migraine variants that are thought to happen only to kids and are precursors to the more common migraines of adulthood. These include paroxysmal vertigo and cyclic vomiting.
Paroxysmal vertigo is described as a sensation of spinning or whirling that comes on suddenly and disappears in a matter of minutes. Kids who experience this may momentarily appear frightened and unsteady, or unable to walk. The vertigo typically goes away by the time a child is 5 years old.
Cyclic vomiting also occurs in young kids and involves repeated episodes of vomiting. The episodes can last for hours or days and are not associated with headache or any other symptoms. Cyclic vomiting usually goes away by the time kids grow into teens.
When Should I Call My Child’s Doctor?
When your child has a splitting headache, it’s easy to worry. Rest assured, though, that only very rarely are headaches a symptom of something serious. However, you should see your child’s doctor if your child has unexplained or recurring headaches over a short period of time or on a regular basis.
Call your the doctor if your child’s headaches:
* occur once a month or more
* don’t go away easily
* are particularly painful
* Another factor to consider is whether or not there are other symptoms along with the headaches. If your child is perfectly well between the headaches, this is less cause for concern. If not, then there’s more cause for concern - symptoms associated with the headaches themselves can help your child’s doctor identify what might be causing the headaches.
Other than nausea, which is common with migraine or tension headaches, you should call child’s doctor if your child also has any of the following symptoms:
* decreased level of alertness
* vomiting
* headache when your child wakes up, or one that actually wakes up your child
* headache following a head injury or loss of consciousness
* headache accompanied by seizures
* visual changes
* tingling sensations
* weakness
* skin rash
* difficulty walking or standing
* neck pain or stiffness
* fever or other signs of infection
* unable to go to school or participate in everyday routines and activities
* How Are Headaches Diagnosed?
* Your child’s doctor will probably want to do a physical examination and get your child’s medical history to help figure out what might be causing the headaches.
The doctor may ask both you and your child about:
* how severe and frequent your child’s headaches are
* whether your child’s headaches have a pattern or change over time
* your child’s concerns and symptoms
* your child’s past health
* your family’s health
* any medications your child is taking
* any allergies your child may have
* any stresses your child might be experiencing
* your child’s diet, habits, sleeping patterns, and what seems to help or worsen the headaches
* To help pin down the problem, doctors often ask parents - and older children and teens - to keep a headache diary, listing each headache, when they happen, how long they last, and a few notes about what might have brought them on.
A good review of your child’s general health is also important. For example, an examination of the back of the eye, called a funduscopic exam, can give your child’s doctor a sense of any increase in pressure inside your child’s brain. This exam is done in the office using an ophthalmoscope, which is a special light that allows the doctor to see the back of the eye.
The doctor also checks to make sure the neck is not stiff, as it would be with meningitis, and that the cranial nerves that work the muscles of the face are working normally. A doctor may also take blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out medical problems that might be causing your child’s headaches, especially if they’re diagnosed as migraines.
What Can I Do to Help My Child?
Treatment for your child’s headache will depend on what your child’s doctor determines is the likely cause. But most everyday headaches can be cared for at home with little medical intervention.
Here are some things you can do to help ease your child’s pain. Tell him or her to:
1. Lie down in a cool, dark, quiet room.
2. Put a cool, moist cloth across the forehead or eyes.
3. Relax.
4. Breathe easily and deeply.
5. Kids with migraines may just want to sleep and may feel better when they wake up. A big part of treating migraines is helping your child to avoid the triggers that may have caused them. That’s where a headache diary can be especially helpful.
You also can give your child an over-the-counter pain reliever such as acetaminophen or ibuprofen. Read the label, though, to make sure that you give your child the right dosage and at the right intervals. And if you have a baby or toddler under 2, call your child’s doctor before giving your little one any pain reliever. He or she will be able to tell you whether you should give it and, if so, how much (based on your child’s weight and age).
And never give aspirin to children younger than 12. Children and teens under age 19 also should avoid taking aspirin during an illness caused by a virus, such as chickenpox or an upper respiratory infection, as this can cause Reye syndrome, a potentially life-threatening condition.
If your child has chronic migraine headaches, the doctor may prescribe a medication to be taken daily as a preventive measure. In deciding whether to put your child on medication, the doctor will consider the frequency of the migraines as well as the potential benefit of the medication versus its possible side effects.
Discuss the medications your child has been taking with your child’s doctor, who will develop a treatment plan that may include approaches to pain relief that don’t involve medicine, such as relaxation, stress reduction techniques, and cutting down on other possible triggers like caffeine.
Keeping track of your child’s headaches and their symptoms and following the doctor’s recommendations are the keys to finding relief for your child’s painful headaches.
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