Headaches in Children

Diagnosis

Diagnosing headaches in children involves a detailed understanding of symptoms, medical history, and a physical examination. Your child’s doctor will try to determine the cause of the headaches and rule out any underlying conditions.

The diagnostic process often includes:

• Headache history: The doctor may ask you and your child to describe the headaches in detail, including frequency, intensity, duration, and possible triggers. You might be asked to keep a headache diary to track patterns and factors that may contribute to the headaches.

• Physical exam: The doctor will check your child’s height, weight, blood pressure, pulse, and examine the eyes, neck, head, and spine for any irregularities.

• Neurological exam: This test assesses your child’s coordination, reflexes, and sensory responses to identify any neurological concerns.

If your child is otherwise healthy and headaches are the only symptom, further testing may not be necessary. However, additional tests may be recommended to rule out other medical causes, such as:

• Magnetic Resonance Imaging (MRI): Uses strong magnets and radio waves to produce detailed images of the brain and its blood vessels. It helps detect tumors, strokes, and other brain abnormalities.

• Computerized Tomography (CT) scan: Provides cross-sectional images of the brain using X-rays to identify possible tumors, infections, or structural issues.

• Spinal tap (lumbar puncture): Involves inserting a needle into the lower back to collect cerebrospinal fluid for analysis. This test is typically done if conditions such as meningitis are suspected.

Treatment

Most children’s headaches can be managed at home with rest, hydration, proper nutrition, and over-the-counter pain relievers. For older children who experience frequent headaches, relaxation techniques and stress management strategies can also help.

Medications

• Over-the-counter (OTC) pain relievers: Acetaminophen or ibuprofen can help relieve mild to moderate headaches. These should be given at the first sign of discomfort and only as directed. Avoid giving aspirin to children recovering from viral infections such as chickenpox or the flu, as it can lead to Reye’s syndrome.

• Prescription medications: Triptans, which are commonly used to treat migraines, can be safely prescribed for children over the age of six. If migraines are accompanied by nausea or vomiting, anti-nausea medications may be used as part of the treatment plan.

Overuse of pain medications can lead to rebound headaches, where frequent medication use makes headaches worse. Always consult your doctor about the correct dosage and duration of any medication.

Therapies
Managing stress and emotional triggers can significantly reduce headache frequency and intensity. Your doctor may recommend behavioral therapies such as:

• Relaxation training: Techniques like deep breathing, meditation, yoga, and progressive muscle relaxation can help children manage pain and stress. These can be learned in classes or through guided resources at home.

• Biofeedback training: This method uses devices to monitor body responses such as heart rate, breathing, and muscle tension. Your child learns how to control these functions to reduce pain and promote relaxation.

• Cognitive behavioral therapy (CBT): A form of talk therapy that helps children understand and manage stress, anxiety, or emotional factors that may contribute to headaches. CBT can improve how children cope with pain and reduce headache frequency.

Combining medication, behavioral therapy, and lifestyle changes often provides the best results for managing childhood headaches effectively.