Headaches in Children

Causes

Migraine headaches

It isn't clear why some people get migraines and others do not. Migraines often run in families. Experts aren't sure what causes migraines.

Tension headaches

The cause of tension headaches also is not clear. Experts believe there may be more than one cause of tension headaches. In the past, doctors believed that tension or spasms of the muscles of the neck, face, jaw, head, or scalp played a role in causing these headaches. Now they think a change in brain chemistry may also cause a tension headache.

What experts know about the causes of headaches is based on research in adults.

Symptoms

Migraine headaches

Migraines are intense, throbbing headaches that can be felt on one side or both sides of the head. The pain also can move from one side of the head to the other. Migraines can make it hard for your child to move around or do daily activities.

Other symptoms of migraines include:

• Nausea, vomiting, or both.
• Sensitivity to light, noise, and sometimes smells.
• Paleness.
• Changes in mood.
• Changes in vision, such as flashing lights or dark spots, before the headache starts. This symptom, called aura, is more common in adults than in children.
• Feeling lightheaded or dizzy.

Without treatment, your child's migraine headache can last as long as 72 hours.

Tension headaches

Tension headaches can last from 30 minutes to as long as several days. For children, these headaches often happen during school or around the time of a stressful event. And they can build up during the day. Symptoms of tension headaches include:

• A constant ache that does not throb or pulse. Your child will probably feel pain or pressure on both sides of the head.
• Tightness around the head or forehead.
• Aching pain at the temples or the back of the head and neck.

Being sensitive to light or noise (but not both) can sometimes be a symptom of tension headaches. But sensitivity to light and noise is more common with migraines.

When to Call the Doctor

Call 911 or other emergency services anytime you think your child may need emergency care. For example, call if your child has:

• A very painful, sudden headache that's different than any he or she has had before.
• A fever with a stiff neck.
• A headache with sudden weakness, numbness, trouble moving parts of the body, vision problems, slurred speech, confusion, or behavior changes.

Call the doctor or seek medical care right away if your child has:

• Headaches after a recent fall or blow to the head.
• New nausea or vomiting, or if your child can't keep food or liquids down.

Watch closely for changes in your child's health. Call the doctor if your child's headaches:

• Last longer than 1 or 2 days.
• Wake him or her from sleep.
• Get worse or happen more often.
• Cause your child to take pain medicines often.
• Do not go away as expected.
• Occur along with a change in personality.

Exams and Tests

Your child's doctor will do a physical exam and ask questions, such as how often the headaches occur and what the symptoms are. The doctor will ask about your child's overall health.

Migraines and tension headaches can be similar to other kinds of headaches, which may have different treatments. So it's important for your child's doctor to find out what kind of headache your child has. The doctor also can make sure your child doesn't have other health problems that may be related to the headaches.

It's common for parents to feel very concerned about their child's headaches. You may feel that more testing is needed to rule out serious causes. But doctors often can find out the type and the cause of the headaches without using other tests.

In some cases, imaging and other tests may be recommended to rule out other health problems, but this isn't common. These tests include:

• An MRI or CT scan, which can show pictures of the brain to rule out problems like tumors or bleeding.
• An electroencephalogram (EEG), which measures the electrical activity in the brain.
• A lumbar puncture, in which a needle is used to remove a small amount of fluid from the spinal canal. The fluid is then looked at for signs of infection.

Medicines

Medicines for migraine headaches

Migraines can be treated with over-the-counter pain relievers, such as children's acetaminophen or ibuprofen. If this doesn't help stop your child's headaches, or if the headaches occur often, your doctor may prescribe medicines.

Medicines for children's migraines are being researched. Sumatriptan is a medicine doctors sometimes prescribe to treat children's migraines. This medicine has been shown to work well in adults with migraines. More research is being done on the safety of migraine medicines for children.

Have your child take his or her medicines at the first sign of a migraine. This helps stop the headache before it gets worse.

Your doctor also may prescribe medicines to help with nausea.

If your child's migraines are severe, happen often, or interfere with school or other activities, your doctor may prescribe a daily medicine to help prevent them. Have your child take that medicine every day, even if he or she does not have a headache.

Medicines for tension headaches

Tension headaches can be treated with over-the-counter pain relievers, such as children's acetaminophen or ibuprofen.

If your child's headaches are severe, happen often, or interfere with school or other activities, your doctor may prescribe a daily medicine to help prevent them. Have your child take the medicine every day, even if he or she does not have a headache.

Giving medicines to children safely

Be careful about giving over-the-counter pain relievers often. Over time, this can make your child's headaches happen more often or get worse. Ask your doctor how often your child should take these medicines.

Here are some other important safety tips:

• Give medicines to your child exactly as your doctor says.
• Read and follow all the instructions on the medicine label. Even medicines labeled for children can harm your child if they're not taken the right way.
• Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.

Learn more about giving over-the-counter medicines to children.

Home Treatment

Home treatment can help relieve your child's headaches. It also can help reduce how often the headaches occur.

When your child has a headache, be sure to give comfort and support. Headaches can be painful and upsetting. Easing stress or anxiety about the headaches is important for helping your child feel better.

Your child may feel stress about missing school or having less time with friends because of the headaches. Talk about any fears or concerns he or she might have.

Work with your child's doctor

Tell your child's doctor about any headaches your child has. The doctor can help you know what type of headache it is so you can choose the best treatment. It may help to find a doctor who has experience treating headaches in children.

Keep a headache diary . A headache diary can help you find a link between your child's headaches and the things that trigger them. Help your child write down when each headache starts, how long it lasts, where it hurts, and what the pain is like (throbbing, aching, stabbing, or dull).

The doctor can help make a treatment plan that your child can follow at home and at school. Tell your child's teachers and other caregivers about the treatment plan. Be sure to discuss any headache medicines your child takes. Encourage your child to always let caregivers know when a headache starts.

To treat migraines or tension headaches at home:

• Give medicines for your child's headache exactly as your doctor says. If your doctor has not prescribed any medicines for headaches, give your child a pain reliever, such as children's acetaminophen or ibuprofen.
• Have your child go to a quiet, dark room to rest. Most headaches will go away with rest or sleep. Watching TV, using the computer, talking on the phone and sending text messages, or reading can often make the headache worse.
• Put a cold, moist cloth or ice pack on the part of the head that hurts. If you use ice, put a thin cloth between the ice and your child's skin. Do not use heat, since it can make the pain worse.
• Gently massage your child's neck and shoulders.
• Give your child water, juice, and other drinks that do not contain caffeine. This may help the headache go away faster. Water is the best choice.

Tell your child's doctor about any new symptoms that occur with a headache, such as a fever, weakness or numbness, vision changes, or confusion. These may be signs of a more serious problem.

Ask your doctor about other treatments that may help your child's headaches, such as biofeedback, counseling, or relaxation exercises. For more information about relaxation exercises, see:

• Stress Management: Doing Progressive Muscle Relaxation.

Prevention

Triggers are things that can cause your child to have headaches. Your child may be able to prevent headaches by avoiding the triggers.

Some things may trigger migraines or tension headaches, including:

• Emotional stress or anxiety.
• Fatigue or lack of sleep.
• Strenuous activity.
• Being hungry or skipping meals.
• Bright lights or sun.

Children may feel stress from schoolwork, sports, social events, a poor self-image, or problems with friends. These pressures can lead to headaches in some children. Talk to your child about what might be causing stress. You can help find ways to cope with the stress, which may help prevent the headaches.

Talk to the doctor if you think your child may be depressed or anxious. Treating these problems may reduce the number of headaches your child has.

Other migraine triggers include:

• Certain foods, such as chocolate, caffeine drinks, and MSG (often used in Chinese food).
• Strong odors or cigarette smoke.
• Changes in the weather.
• Menstruation or other changes in hormones.
• Being dehydrated.

Other tension headache triggers include:

• Muscle strain in the neck or shoulders, sometimes from poor posture.
• Grinding or clenching teeth.

Keep a headache diary

Keeping a headache diary helps you find a link between your child's headaches and the things that trigger them. Help your child write down when each headache starts, how long it lasts, where it hurts, and what the pain is like (throbbing, aching, stabbing, or dull).

Write down any other symptoms your child has with the headache, such as nausea or being sensitive to bright light or noise. List anything you think might have triggered the headache.

Remember that it might take up to 24 hours for some triggers to cause a headache. Other triggers can lead to a headache right away.

Show the headache diary to your child's doctor at each visit. The doctor can help you and your child figure out what the triggers are. When you know your child's triggers, you can help your child avoid those things.

Migraines and tension headaches

To prevent migraines and tension headaches:

• Find healthy ways to help your child manage stress. Don't let your child's schedule get too busy or filled with stressful events.
• Make sure that your child drinks 4 to 8 glasses of fluid a day. Avoid drinks that have caffeine. Many popular soda drinks contain caffeine.
• Make sure that your child gets plenty of sleep and keeps a regular sleep schedule. Most children need to sleep 8 to 10 hours each night.
• Encourage your child to get plenty of exercise, without overdoing it.
• Limit TV, video games, and computer time.
• Make sure that your child does not skip meals. Provide regular, healthy meals.
• Keep your child away from smoke. Do not smoke or let anyone else smoke around your child or in your house.
• Talk to your child's teachers if your child is having problems with schoolwork. Make sure that the level and amount of schoolwork is appropriate for your child.