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Headaches

What Are Headaches?

Headaches cause pain somewhere in the head or neck. They're very common in kids and have a wide range of causes.

It's important to understand how to recognize when a headache is just a passing pain and when it's something more and needs medical care.

What Are the Signs & Symptoms of a Headache?

Two common kinds of headaches that kids get are tension headaches and migraines.

Tension headaches cause pain often described as:

  • constant pressure around the front and sides of the head, which can feel like a rubber band is stretched around it
  • squeezing or pressing
  • dull
  • aching

Migraine headaches can cause:

  • pounding, throbbing pain on one or both sides of the head
  • dizziness
  • stomachaches
  • nausea and/or vomiting
  • seeing spots or halos
  • sensitivity to light, noise, and/or smells

Most migraines last from 30 minutes to several hours. Some can last as long as a couple of days.

Sometimes people with migraines:

  • just don't feel right. Light, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to perform physical activities can make the pain worse.
  • get auras, a kind of warning that a migraine is on the way (usually about 10 to 30 minutes before the start of a migraine). The auras may only be seen in one eye. Common auras include blurred vision, seeing spots, jagged lines, or flashing lights, or smelling a certain odor.
  • experience a migraine premonition hours to days prior to the actual headache. This is slightly different from auras and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.
  • have muscle weakness, lose their sense of coordination, or stumble.

Unfortunately, parents of an infant or toddler who are unable to say what hurts may not be able to tell if their little one is having headaches. Young kids with headaches may be cranky, less active, may vomit, or look pale or flushed.

Some other problems that are sometimes seen in kids with migraines include:

Paroxysmal vertigo- described as a sensation of spinning or whirling that comes on suddenly and disappears in a matter of minutes. Kids who experience this may momentarily appear frightened and unsteady, or unable to walk. The vertigo comes and goes, and typically resolves by the time a child is 5 years old.

Cyclic vomiting- repeated episodes of vomiting. The episodes can last for hours or days and are not usually associated with headache. Cyclic vomiting usually goes away by the time kids grow into teens.

Abdominal migraine- repeated episodes of abdominal pain. The pain is typically dull, in the middle of the abdomen, and very painful. Sometimes it is accompanied by loss of appetite and mild nausea or vomiting. The child might look very pale.

What Causes a Headache?

Headaches are thought to be caused by changes in chemicals, nerves, or blood vessels in the area. These changes send pain messages to the brain and bring on a headache.

Some of the many potential headache triggers include:

certain medications (headaches are a potential side effect of some)

too little sleep or sudden changes in sleep patterns

skipping meals

becoming dehydrated

being under a lot of stress

having a minor head injury

using the computer or watching TV for a long time

vision problems

allergies (hay fever)

menstruation

experiencing changes in hormone levels

taking a long trip in a car or bus

listening to really loud music

smoking

smelling strong odors such as perfume, smoke, fumes, or a new car or carpet

drinking or eating too much caffeine (in energy drinks, soda, coffee, tea, and chocolate)

certain foods (such as alcohol, cheese, nuts, pizza, chocolate, ice cream, fatty or fried food, lunchmeats and hot dogs, yogurt, aspartame, and MSG)

In some cases, headaches are caused by certain infections, such as:

ear infections

viral infections, like the flu or common cold

strep throat

sinus infections

Lyme disease

Who Gets Headaches?

Headaches are common in kids and teenagers of all ages.

Headaches (especially migraines) often are hereditary. So if a parent, grandparent, or other family member gets them, there's a chance that a child may get them too. Some kids are more sensitive to certain triggers (such as those listed above) than other kids.

How Are Headaches Diagnosed?

Your doctor will do a physical exam and get your child's medical history to help discover what might be causing the headaches. Let the doctor know:

how severe and frequent the headaches are

when the headaches first started

what the headaches feel like, and where they hurt

whether the headaches have a pattern or change over time

any other symptoms that your child experiences with the headache

any injuries that have occurred recently

anything that triggers the headaches

your child's diet, habits, sleeping patterns, and what seems to help or worsen the headaches

any stresses your child might be experiencing

any past medical problems your child has had

any medications your child is taking

any allergies your child may have

any family history of headaches

To help pin down the problem, doctors often ask parents — and older kids and teens — to keep a headache diary, listing all headaches, when they happen, how long they last, and a few notes about what might have brought them on.

The doctor will do a complete neurological exam including looking in the eyes, testing nerves, and having your child do things like walk or touch his or her nose. A doctor also may order blood tests or imaging tests, such as a CAT scan or MRI of the brain, to look for medical problems that might be causing headaches.

How Are Headaches Treated?

Treatment for your child's headaches will depend on what the doctor determines is the likely cause. But most everyday headaches can be cared for at home with little medical intervention.

To help ease your child's pain, have him or her:

Lie down in a cool, dark, quiet room.

Put a cool, moist cloth across the forehead or eyes.

Relax.

Breathe easily and deeply.

Make sure your child has had something to eat and drink. Kids with migraines may just want to sleep and may feel better when they wake up. A big part of treating migraines is avoiding the triggers that may have caused them. That's where a headache diary can be especially helpful.

You also can give your child an over-the-counter pain reliever such as acetaminophen or ibuprofen. Read the label, though, to make sure that you give the right dosage at the right intervals. If you have any questions about how much to give, check with the doctor. And if your child is under age 2 or has other medical problems, call your doctor before giving your little one any pain reliever. Your doctor will be able to tell you whether you should give it and, if so, how much (based on weight and age).

Never give aspirin to kids or teens unless specifically directed to by a doctor. Aspirin can cause Reye syndrome, a potentially life-threatening condition.

If your child has frequent migraine headaches, the doctor may prescribe a medication to be taken when the headaches come on or daily as a preventive measure. In deciding whether to put your child on medication, the doctor will consider the frequency of the migraines and discuss the potential benefit of the medication versus its possible side effects.

Discuss pain management with your doctor, who will develop a treatment plan that may include approaches that don't involve medicine, such as relaxation, stress reduction techniques, and avoiding possible triggers.

What Else Should I Know?

When your child has a splitting headache, it's easy to worry. Rest assured, though, that only very rarely are headaches a symptom of something serious- like a brain tumor or meningitis. However, you should contact your doctor if your child has unexplained or recurring headaches over a short period of time or on a regular basis.

Call the doctor if your child's headaches:

occur more frequently than usual

don't go away easily

are extremely painful

happen mostly in the morning (when your child wakes up, especially if the headache wakes up your child)

Also note whether other symptoms accompany the headaches, which can help the doctor identify what might be causing them. Call the doctor if your child also has any of these symptoms:

decreased level of alertness

vomiting

headache following a head injury or loss of consciousness

headache accompanied by seizures

visual changes

tingling sensations

weakness

clumsiness

skin rash

difficulty walking or standing

difficulty speaking

neck pain or stiffness

fever or other signs of infection

change in personality

drinking or peeing a lot 

unable to go to school or participate in everyday routines and activities

Date reviewed: September 2018