Children Get Headaches Too !
By Paul Winner, DO, FAAN
Headaches can begin at any age, even as young as two to three years of age. The number of new severe headaches peak during adolescence. Headache symptoms in children do not exactly mirror those in adults. As a result children often remain without a correct headache diagnosis for many years until the episodes take on a more adult pattern. Migraine headache in adults is associated with disability that lasts for up to 3 days, with nausea, vomiting, and/or sensitivity to light and sound.
Since children can experience severe headaches and are not always able to describe what they are feeling, it’s important for parents to provide information. With careful observation, and insightful questioning, you can get an idea about your child’s headaches and help to get the right diagnosis.
Headache Differences in Children
Episodic headaches experienced by children may actually be migraine with or without aura. There are some noticeable differences in migraine when comparing clinical symptoms between children and adults:
- The headaches may be shorter, lasting only an hour or two. Frequently, they’re over in less than an hour when they first present.
- The episodes don’t occur as often. They may happen only once a month, or every few months.
- The pain tends to be more across the forehead [ bi-frontal ] than on one side of the head [ unilateral ]. As children and adolescents get older, the pain tends to be more unilateral.
- In young children even before they complain of headache, they may get other childhood migraine syndromes. The two most common are cyclic vomiting syndrome and abdominal migraine.
- Cyclic vomiting syndrome consists of regular predictable episodes of vomiting several weeks apart. These vomiting episodes can be very severe and can lead to dehydration.
- Abdominal migraine seems like migraine except instead of headache, children complain of stomach aches. The pain is vague or cramping around the belly button.
Since episodic abdominal pain or vomiting may be due to a gastroenterological problem, parent should consider having a gastroenterologist assess their child before initiating migraine therapies.
- Children may not report many of the common symptoms normally associated with a migraine headache, such as sensitivity to light or sound. They may also complain of difficulty with concentration. (These symptoms may be inferred from their behavior.)
Getting Help for Your Child
If your child is experiencing episodic headaches it is important to get the right diagnosis as soon as possible by having your child be formally evaluated by their physician or Allied health care professional. Once an accurate diagnosis is made, effective acute and if necessary preventive therapy can be given. Acute therapy should ideally stop a headache or at least reduces the pain within one to 2 hours and preventive treatment reduces headache frequency by 50% or greater. If the initial therapies are not effective, consider seeing a Pediatric Neurologist or Headache Specialist who is comfortable in caring for children with headaches.
Paul Winner, DO, FAAN, Director, Palm Beach Headache Center, West Palm Beach, FL, Clinical Professor of Neurology, Nova Southeastern University, Fort Lauderdale, FL.