Headaches in children

Headaches are common in children, although the frequency and severity can vary. According to research, about 10% to 20% of children experience headaches at some point. Headaches can occur at any age, and as children grow older and move into adolescence, the frequency of headaches tends to increase.

Studies indicate that by age 15, about 75% of children have had at least one headache. Migraine headaches are quite common in children and adolescents. About 10% of school-age children suffer from migraines, and that number increases to 28% by the age of 15 to 17.

However, it is important to remember that while headaches are common, frequent or severe headaches should be evaluated by a healthcare provider as they can sometimes be a sign of an underlying condition. Furthermore, headaches can impact a child’s quality of life, including their school performance and social activities, which is why it’s important to address and manage them properly.

There are various types of headaches that can affect children, common primary headache causes include tension headaches, migraines, and cluster headaches.

Tension headaches: These are the most common type of headaches in both children and adults. Tension headaches typically cause a mild to moderate pain that feels like a tight band around the head. They may be triggered by stress, anxiety, poor posture, screentime or lack of sleep.

Migraines: Migraines are less common in young children but can occur in older children and adolescents. Migraines often headaches that are more severe in pain score, usually with a pulsating or throbbing-like quality. They are often accompanied by other symptoms such as nausea, vomiting, sensitivity to light and sound, and sometimes visual disturbances.

Cluster headaches: Cluster headache is a type of primary headache disorder that are rare in children, but can still occur. These headaches usually causes very severe intense pain on one side of the head, and are accompanied by symptoms like redness and watering of the eye, nasal congestion, and restlessness. Cluster headaches tend to occur in clusters over a period of weeks or months, with remission periods in between.

Headaches in children can have various triggering causes such as sleep issues, including irregular sleep patterns, sleep deprivation or poor sleep quality. It can also be triggered by environment factors such as stress, excessive screentime, fatigue, eye strain, dehydration, certain foods, medication side effects and underlying medical conditions. If a child’s headaches are frequent, severe, or significantly impact their daily activities, it is recommended to consult a healthcare professional for a proper evaluation of the underlying cause, aid in trigger identification and formulating an appropriate medical management plan.

For pain relief, over-the-counter medications like paracetamol (Panadol) or ibuprofen (Nurofen) can be used, but always follow the dosing instructions or consult with a healthcare provider.

It’s worth noting that the management of primary headaches in children at home involves a combination of healthy lifestyle modifications, such as ensuring adequate hydration, regular meals, healthy sleeping habits, appropriate amount of screen time, and engaging in regular outdoor physical activity.

As stress or anxiety is a common trigger for tension-type headaches and migraines, teaching your child stress management techniques like deep breathing or relaxation exercises can also be helpful. Communicating with your child’s teachers and school is also helpful in making sure everyone is aware of the situation and know what to do if a headache occurs.

Occasionally vision problems can lead to headaches. If you observe that your child is squinting, rubbing their eyes frequently, or having trouble seeing the board at school, this could be a sign of vision problems. Extended periods of close-up works like reading or using a computer, poor lighting, or uncorrected vision problems can cause excessive eye strain and headaches. Encourage regular breaks from screens, proper lighting, and regular eye exams.

If you suspect your child has a vision problem, it’s a good idea to get their eyes checked by an optometrist or ophthalmologist. It is also important to note that in cases where the child has severe headaches accompanied by visual disturbances, it is crucial to seek medical attention as it may indicate a more serious underlying condition.

Yes, children can get migraines. In fact, migraines can start at any age, and they are quite common in children and teenagers. Migraines in children may present differently than in adults. For example, they may last for a shorter time (only an hour or two) and the child may not necessarily complain of a headache, but instead may look pale, feel dizzy, or have abdominal pain. Location and severity of the headache may also differ from that of the adult. It is often not easy for the adult to identify the child’s headache, or for the child to express their headache nature.

Most headaches in children are not serious. However, if the headaches are frequent, severe, or accompanied by other symptoms such as vomiting, visual disturbances, balance problems, or personality changes, it is important to seek medical attention. This is especially true if the child’s headaches are waking them up from sleep, are significantly worsening over time, or are associated with recent trauma to the head. These could potentially be signs of a more serious underlying condition. If over-the-counter pain relievers are not effective, or if your child’s headaches are causing them distress or interfering with school or other activities, it is also a good idea to consult a healthcare provider.

A neurologist will do a clinical evaluation comprising of a thorough medical history taking and physical examination. It will be useful if a headache diary, or information such as the headache’s quality, frequency, severity can be provided to the doctor. If there is a need for it, further diagnostic test such as MRI or CT brain scan may be ordered if there are concerns or unusual features of the headache

Treatment of the child’s headache is very much dependent on the cause of the headache. Secondary headaches (which means headache due to another underlying condition) requires further evaluation and treating the underlying cause. Primary headaches such as migraine or tension-type headaches requires a combination of medication therapy (if needed), as well as lifestyle evaluation and advice. Causes and triggers will be unique to each individual and requires a tailored management by the healthcare provider.