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Headaches (child): Treatment, symptoms, advice and help

Headaches usually occur in the older child, frequently in the over 10 year olds. Younger than that children more usually complain of tummy ache (Abdominal pain). Headaches can be worrying as normally there is little outward sign of anything wrong, yet the child is complaining of pain or discomfort and may be missing school, sometimes totalling several weeks in a term.


The longer the headaches continue the greater the anxiety as there can be concerns of something happening in the head, especially a growth.

Diagnosis and Treatment
Headaches are really very common in children, but only very rarely is there something physical underlying them. What is important is to try to work out which headaches are the worrying ones.

Tension headaches are the most common type. Usually it is difficult to notice anything unusual physically about the child, although sometimes the face may be slightly pale. The headaches can occur at any time of the day, but are not present when the child first awakes and are relieved by sleep. Typically they last an hour or so and the pain can be relieved by simple pain killers such as paracetamol. The cure though is to find the underlying cause of the stress or worry.

If a child complains of headaches, but is able to continue at school and join in sports activities fully without the headaches worsening, then it is unlikely that there is a serious problem causing the pain. Complaints of headaches every day and/or lasting all day are again unlikely to be caused by anything serious, unless the headaches are worsening over time. Lastly, if the headaches have been present for more than 8 months they are very unlikely to be caused by such problems as cancers in the head which grow steadily so the child would be very sick if the growth had not been diagnosed before 8 months.

Features which could be worrying are headaches that cause a child to wake during the night. Both tension headaches and migraine are relieved by sleep. Headaches which are present when the child wakes and improves over the morning or are accompanied by vomiting or a change in consciousness such as drowsiness may also have a physical cause underlying them.

Migraine occurs in childhood, generally in children over 8 years old and normally in children over 10 years old. Younger than 8 years old children may have abdominal migraine which causes tummy pain (Abdominal pain). More often than not there is a family history of migraine as it is thought that migraine is transmitted to children in a dominant way. That is, if a parent suffers from migraine their children each have a 50:50 chance of inheriting migraine. 

The migraine may start with an aura. This is a kind of forewarning, frequently of changes in vision, such as haloes around lights, blind spots or alteration in the way things look. Then the headache starts, generally confined to one side of the head. The child's face becomes deathly pale and they may vomit. The child normally wants to avoid light and to sleep, which will relieve the pain.

Treatment is more difficult than for tension headache and specific treatment for migraine may be needed. There are now preventative treatments with tablets being taken daily.

Outcome
Some children are clear as to what triggers the migraine, chocolate, cheese or shell fish, but often there is no obvious trigger so drug treatment is necessary to relieve what can be very unpleasant pain.