Headaches in Children – Diagnosis and Treatment
Diagnosis
Doctors use a step-by-step approach to find out what causes headaches in children. The process often starts with a talk about symptoms and moves to more specific exams or tests if needed.
This helps the doctor rule out more serious problems such as infections or neurological conditions.
Symptoms checked may include:
- Nausea
- Vomiting
- Fever
- Dizziness
- Double vision
- Weakness
- Changes in personality or behavior
- Signs of acute headache, like sudden severe pain
- Warning signs of meningitis
Getting a Careful History
Doctors often ask the child and parents many questions about the headaches. They look for patterns like how often the headaches happen, how strong the pain is, and what seems to trigger them.
Keeping a headache diary helps track these details. Any connection with infections, allergies, or recent colds is important.
Physical and Neurological Checks
A physical exam includes basic measurements:
| Measured Item | Why It Is Checked |
|---|---|
| Height and weight | To check for growth and development |
| Head size | To look for abnormal head growth |
| Blood pressure & pulse | To find signs of other medical issues |
A neurological exam checks if the child has problems with movement, balance, coordination, or senses. This is useful if the child has symptoms like double vision, weakness, or changes in balance.
Special Tests
If the headache is unusual or linked to other symptoms, the doctor might order special imaging or other tests:
- MRI Scan: Shows detailed images of the brain and its blood vessels, helping the doctor find tumors, infections, stroke, or unusual brain structure.
- CT Scan: Uses X-rays for a quick look at the brain to check for injuries, infections, or other problems.
- Spinal Tap (Lumbar Puncture): The doctor performs this test if they think there could be an infection like meningitis, which often causes fever, stiff neck, and headache with vomiting or confusion.
Additional Details
Families should note signs like personality changes, loss of consciousness, or ongoing vomiting along with the headache. Sharing this information with the clinic helps the care team decide the next steps or if emergency care is needed.
Treatment
Pain Relief Medicines
Parents often use pain relievers available without a prescription, like acetaminophen or ibuprofen, to ease headaches in children.
These medicines work best when taken soon after headache symptoms start. Parents should always check the label and follow dosing instructions.
Parents should not give aspirin to children or teenagers who are recovering from chickenpox or flu-like symptoms because it can cause a rare but serious illness called Reye’s syndrome.
Doctors may prescribe treatments for children with regular or severe headaches. Certain prescription migraine-specific medications can help children over 6 who experience migraine headaches.
If a child’s headaches cause nausea or vomiting, a doctor might suggest medication for these symptoms too.
Caution: Using pain relievers too often can actually cause more headaches, known as medication overuse headaches. All medications, including those you buy without a prescription, can have side effects or become less effective if used too much.
Parents should talk with a healthcare provider before starting regular medicines to make sure it is the right choice.
Common Medications Table
| Name | Type | Notes |
|---|---|---|
| Acetaminophen | OTC pain reliever | Take at first headache sign |
| Ibuprofen | OTC NSAID | Not for stomach issues |
| Migraine-specific medications | Prescription (Migraine) | For children >6 years |
| Caffeine | Sometimes included | Can help or trigger headaches |
| Anti-nausea meds | Prescription | For migraine with nausea |
Behavioral and Stress Management Techniques
Learning to relax and handle stress plays an important role in managing headaches, especially for children who have them often.
Relaxation methods include deep breathing, yoga, meditation, or progressive muscle relaxation (tensing and relaxing muscles one at a time). Counselors can teach these techniques, or families can learn them at home from books or videos.
Biofeedback uses sensors to highlight body signs such as muscle tightness or heart rate. Children can learn how to control these signs, which may help lessen pain.
Cognitive-behavioral therapy (CBT) can also help. In CBT, a trained counselor helps children understand stress and teaches coping skills. This can lower the number of headaches and make them less severe.
Further Guidance and Support
Parents and caregivers should encourage children to rest in a quiet, dim room and offer water and light snacks when a headache occurs. Good sleep habits, regular meals, staying hydrated, and managing screen time can help prevent headaches.
If headaches are severe, happen often, or don’t get better with home care, families should reach out to a healthcare provider for further advice.
Self-Care
Families can take steps at home to help manage headaches and migraines in both children and adults. Over-the-counter pain medicines can relieve headache pain if used properly.
Always check the label for the correct dose and do not use these medicines more often than the instructions say.
Rest is important. Lying down in a quiet, dark room can ease tension headaches and migraine symptoms. Many times, resting or sleeping is enough to reduce the pain, especially for headaches in children.
A cool, wet cloth placed on the forehead may help during a headache attack. This simple step can provide comfort and lower stress.
Skipped meals can sometimes trigger headaches or make them worse. Giving a healthy snack, such as fruit, whole-wheat crackers, or low-fat cheese, can help when a child has not eaten for a while.
A headache diary may also be useful. Tracking headache patterns, triggers like lack of sleep or stress, and what helps relieve pain can guide future care and prevention.
Other Therapeutic Approaches
Many families look to different options beyond standard medicine to help manage children’s headaches.
Some dietary supplements like riboflavin, magnesium, Coenzyme Q10, and vitamin D are sometimes used, but caregivers should consult a doctor before starting any of these due to possible drug interactions.
Other methods, such as massage and acupuncture, can help lessen headache symptoms. Massage may help reduce tension and manage stress.
Getting Ready for Your Visit
Steps You Can Take Before the Visit
To prepare for your child’s appointment with their pediatrician or family doctor, keep a written record of all symptoms, when they started, how long each episode lasted, and possible triggers. Using a headache diary helps organize this information.
Create a list of all medicines, vitamins, or supplements your child is using. This helps the doctor understand possible causes and avoid medication conflicts.
Prepare a set of questions for the doctor. For example:
- What is the likely reason for these symptoms?
- Are any tests or scans needed?
- What are the possible treatment options?
- Is prescription medicine needed, or will over-the-counter medicine be enough?
- Are there steps to take at home to reduce or prevent headaches?
Keeping organized notes makes the visit more helpful. The following table is a sample way to organize some of this information:
| Detail | Notes |
|---|---|
| Symptom start date | |
| How often headaches occur | |
| How long each lasts | |
| Any triggers | |
| Medications taken | |
| Family history |
What the Doctor Might Do or Ask
During the appointment, the pediatrician may ask about your child’s medical history, how the headaches have changed over time, and if anyone else in the family has similar symptoms. Common questions include:
- When did the headaches start?
- How often do they happen?
- How long does each headache last?
- Are there any other symptoms (such as dizziness or nausea)?
- Has anything helped or made things worse?
- Which treatments or medicines have you tried so far?
The doctor will also look for any warning signs that could mean something more serious. They may check your child’s nerves and reflexes, and in some cases, may refer you to a specialist like a neurologist.
