My Child Has Headaches: What Should I Do?

Did you know twenty percent of adults who develop headaches in their lifetime will begin having them before ten years of age? Headaches are a common problem in children, which is why it’s important to know when to treat them at home and when it’s time to seek a neurologist. Through this blog, I’m answering some of the most common questions we receive regarding headaches: 

What are headaches and how do they affect kids? 

There are many types of headaches and causes, 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 migraine, messages from these areas are sent, releasing chemicals that inflame and irritate the nerves and vessels. This can make even normal sensations, such as lights or noise, seem more intense and painful. Children may need to “sleep it off”, but occasionally headaches are debilitating, causing children to miss activities and even school. If this is the case, parents may seek the help of their pediatrician. 

When to seek a neurologist vs. when not to/treat at home: 

Often, headaches are easily treated at home, with sleep and/or over-the counter medication. When headaches continue despite these interventions, are frequent, or if there is question regarding the cause of the headache, pediatricians will usually refer to a neurologist. If the following “red flags”, listed below, occur, you should seek the help of a neurologist. 

What are the red flags parents should know about? 

Headaches that change over time, increase in frequency, and/or involve the following symptoms raise concern: visual changes or loss of vision; weakness and/or loss of sensation; headache on awakening with or without vomiting; confusion or difficulty thinking. These symptoms signal a concern for secondary headaches (a headache caused by an underlying problem). Note that migraines can involve these symptoms, but other secondary causes should be considered first. If any of these issues are present, parents should let their pediatrician know. 

What can you expect after reaching out to a neurologist? 

Your neurologist will likely recommend you keep a diary of the headaches (e.g. frequency, triggers, etc.). They will advise avoiding any known headache triggers and suggest treatments for the headaches. Treatment may include preventative medication and/or medicine to stop the headaches once they begin. Also, they may be referred to physical therapy, psychology, or another specialty if there are other concerns. Imaging (e.g. MRI brain) is obtained when there is concern that the headache may be due to an underlying structural reason. Other tests may also be considered. A thorough history and neurologic examination is necessary in making an accurate diagnosis. For more information about Texas Children’s Pediatrics, visit here and to learn about our neurology department, visit here.