Headaches in Children
I realized that I am among the lucky minority – I had never experienced a bad headache till I joined post graduation. Statistics say that 90% of school going children now experience a troubling episode every year. Around 10% have recurrent conditions such as tension headaches and migraine. So what could trigger a sudden headache in a child? The cause maybe problems related to the brain and nerves or other body systems. #Fever associated with bodypain: It is quite common to experience head ache during episodes of viral fever. A headache does not necessarily mean an infection of the brain (meningitis or encephalitis). Rest and pain relief medication will suffice. The following are indications to see your paediatrician immediately * Recurrent Vomiting * Disturbances in vision * Difficulties in moving limbs * Slurring speech * Disorientation #Sinusitis and Ear infections: These can be accompanied by headache. There could also be nose block, sore throat or discharge from the nose/ears. #Eye conditions Burning and tearing of eyes with dizziness may occur if the child has a squint needing correction and vision problems like refractive errors and astigmatism. #Tooth problems #Injury A fall may cause an internal injury so look out for these warning signs to see your doctor *fainting and unresponsiveness *vomiting *discharge/bleeding from the ears/nose or mouth #Hypertension (increased blood pressure) This can also be a cause of unexplained fatigue and headache in children. Apart from these, the primary causes for recurrent headache are due to psychogenic causes(stress headaches) or blood vessel related conditions(or migraines).These are inherited conditions so look out if others in the family experience them. Psychogenic or tension headaches come on with a mild to moderate aching sensation frequently. Older children may describe it as a tight band or weighty feeling on the head. Personality features
that are often described in children with these headaches are sensitivity, being overly concerned for approval by others, shyness and fear of making mistakes. While medications offer only symptomatic relief it is important to address deeper issues with such children. They will benefit more from relaxation techniques and opportunities for creative expression. They need to understand and regulate their emotions. Migraines differ from all headaches in character and management. They have an episodic occurrence and can be described as throbbing or pulsatile with great severity. They may occur with associated events like painful eye movements, intolerance to noise or light, transient blindness or visualising lights or blurred patterns in the field of vision, abdominal pain and nausea (termed the “aura�of the migraine) There are specific triggering factors like *hunger *foods like cheese, chocolate, and Chinese dishes with monosodium glutamate *loss of sleep *hyper stimulatory scenarios with flashy lights and noise like game zones, concerts etc Keeping a record of precipitating events can help immensely in anticipatory guidance. Medications can be taken both symptomatically and prophylactically. A brain lesion like a tumour is often a concern when a child complains of headache. But this is infrequent and doctors investigate for one when we notice certain associated factors like *headache worsening on waking or awakening a child *fits *abnormal signs on examination Generally paediatricians do not go for expensive imaging techniques like a CT scan or MRI for headache even at the request of parents. With a good history and examination your paediatrician will be able to categorise and prescribe suitably for the child’s headache. Also see more info @ http://www.parentedge.in