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    Headache In Children

    Overview
    Causes
    Risk Factors
    Prevention
    When To Seek Help
    Treatment Options
    Where To Seek Treatment
    Singapore General Hospital
    Contributed by Dept of Neonatal & Developmental Medicine

    Overview

    Headaches occur in over 90% of school-age children and are generally not serious. It is a common symptom and in most cases, the causes are simple. It may be due to a lack of sleep, hunger or even anxiety before an exam. Children get the same types of headaches adults do, such as tension headaches and migraines. However, young children generally do not complain of headaches so any such complaints, especially if persistent or recurrent, should be taken seriously. Certain features of a headache will point to important conditions that may need urgent treatment.


    Causes

    The following factors can make your child more prone to headaches:

    • Head injury. Accidental bumps and bruises can cause headaches. Most head injuries are minor. But seek medical help immediately if the child has been vomiting, bleeds from the nose or ears, is drowsy, walks unsteadily, loses consciousness, has a seizure, complains of blurred vision or a steadily worsening headache after a bang on the head.
    • Illness and infection. Headache is a frequent symptom of many common childhood illnesses such as the common cold, allergic rhinitis and ear and sinus infections.
    • Emotions. Anxiety and stress caused by problems with parents, teachers or friends can cause headaches in many children.
    • Environment. Weather changes, loud noises, odours, and bright lights can all contribute to headaches.
    • Genetic predisposition. If there is a family history of bad headaches, the child will have a higher risk of getting them too. This is particularly true for migraines, which tend to run in families.
    • Rare causes: brain infection and brain tumour.

    Risk Factors

    Headaches are more common in children older than 10 years old and children who have a family history of headaches or migraines.


    Prevention

    The first step to preventing headaches is to know what triggers the headache. It could be stress (from school or friends), anxiety, depression, a change in routine or sleep pattern, bright light, loud noises or certain food or beverage. Sometimes, too much physical activity or too much sun exposure can trigger migraines in children.

    To prevent headaches triggered by a change in lifestyle, make sure your child practise good habits such as getting enough sleep, eating healthily and exercising.

    Parents should also be alert for things that may cause stress in the child’s life, such as problems with schoolwork or with peers. Removing the stress can help prevent your child from developing a headache.

    It is also good to keep a food diary so that you know what kind of food or beverage trigger headaches in your child. Make sure your child avoid those foods.


    When to seek help

    While the occasional headache is nothing to worry about, sometimes it can be a symptom of a more serious condition. That is why it is important to pay attention to the symptoms of your child's headache, and to see a doctor if the headache seems unusual, occurs often, or disrupts his daily activities.  

    The following symptoms should prompt you to seek medical attention:

    • Headaches that wake a child from sleep or occur in the early morning
    • Early morning vomiting without nausea
    • Worsening or more frequent headaches
    • Personality changes
    • Complaints such as "this is the worst headache I've ever had!"
    • The headache is different than previous headaches
    • Headaches with fever or a stiff neck
    • Headaches with changes in vision
    • Headaches that follow an injury
    • Headaches with seizures or fainting episodes. In these cases, cranial imaging or other investigation may be needed to exclude intracranial causes.

    Treatment Options

    Treatment depends on your child’s age and the type, severity and frequency of headaches.

    Over-the-counter and prescription medicines can treat your child’s headache effectively. These include acetaminophen and ibuprofen. For children with more severe headaches, your doctor may prescribe pain relievers or non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ketorolac tromethamine.

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