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
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.
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.