My child has headaches, so what should I do?

Did you know that 20 percent of adults who develop recurring headaches in their lifetime would begin enduring them before 10 years of age? In most cases, infection, minor head trauma or high levels of stress and/or anxiety often cause chronic headaches in children. It's important to pay attention to your child's headache symptoms and know when it’s appropriate to treat them at home versus seek outside help from a pediatrician or pediatric neurologist. Through this blog, I’m answering some of the most common questions we receive regarding headaches.

What are headaches and how can they affect my child?

There are many types of headaches and various causes behind them, but most commonly, we see children with migraines and tension-type headaches. These headaches are caused by several parts of the brain, including blood vessels and pain centers. During a headache, messages from these areas are sent, releasing chemicals that inflame and irritate the nerves and vessels. This can make even normal sensations, such as light or noise, seem more intense and painful. Children usually need to just “sleep [the headache] off,” but some headaches can be debilitating, causing them to miss out on normal activities, including school. If this is the case, parents should consider seeking help starting with their pediatrician.

When should I consider seeking help from a pediatric neurologist?

Often, headaches are easily treated at home with sleep and/or over-the-counter pain relief medication. When headaches persist despite these interventions, occur frequently, or if there is question regarding the cause behind your child’s headaches, your pediatrician will typically refer your child to a pediatric neurologist.

If the following “red flags,” listed below, are present, you and child’s pediatrician should seek a neurologist for specialty care.

What are the red flags I should be aware of?

You should be concerned if your child endures headaches that change over time, increase in frequency and/or involve any of these following symptoms:

• Loss of vision or visual changes
• Weakness or loss of sensation
• Headache on awakening, with or without vomiting
• Confusion or difficulty thinking

These symptoms signal a concern regarding secondary headaches, a headache caused by an underlying problem. Please note that migraines can involve these symptoms, but other secondary causes should be considered first. If any of these issues are present, you should consider informing your child’s pediatrician.

What should I expect when visiting a neurologist?

Your pediatric neurologist will likely recommend you and your child keep a diary on the headaches, including information on frequency, triggers, etc. They will advise avoiding any known headache triggers and suggest various recommended treatments for the headaches. Treatment might include preventative medication and/or medication to stop the headaches once they begin. Also, your neurologist could refer your child to physical therapy, psychology or a variety of other specialty care providers with helpful insight. Imaging is obtained when there is a concern that the headaches are coming from an underlying structural issue. Other tests might also be considered. A thorough history and neurologic examination of your child is necessary in providing an accurate diagnosis.

For more information about the Headache Clinic at Texas Children’s Hospital, click here. If you’re interested in learning more about Texas Children’s Neurology and Developmental Neuroscience department, click here. If your child is seeing one of our pediatricians, you can also download the free Texas Children’s Pediatrics app, which has an easy-to-use symptoms checker and reliable access to your MyChart patient information.