Headaches in children

A headache describes pain felt anywhere in the head. Headaches are common in children and adolescents and can range in severity and frequency.1 An Australian study showed that only 36.8% of children between the ages of 10 and 18 years had never experienced a headache.2 Furthermore a study conducted in 2006 showed that 3.7 million children between the ages of 4 and 17 living in America had experienced a headache in the previous 12 months.

Types of headaches

Headaches can be classified as primary or secondary. Common primary headaches in children and adolescents are tension headaches and migraine headaches.1 Tension headaches often present as a band of pain around the head bilaterally and can be described as dull, achy or pressure type pain. Migraine headaches often present on one side of the head and are described as a throbbing type of pain. Migraine headaches may be accompanied with light and sound sensitivity, dizziness, nausea, vomiting and visual disturbances. Children with primary headaches may have family members who also experience headaches.

Secondary headaches are triggered by a known underlying cause such as dysfunction in the cervical spine, mild illness or dehydration. 

When toddlers and children are younger they may be unable to voice their pain, thus identifying a headache may be more difficult. Some tell-tale signs and symptoms may include holding their face, hitting their head against the floor, or showing sensitivity to light or disinterest in food. Infants may show signs of grimacing, ineffective latching, or positional discomfort when feeding.4,5 Children suffering from a migraine may display signs of lethargy, mood swings, yawn excessively, crave food and drink, turn pale or seek a dark and quite space.4,5 Interestingly, children may not experience head pain at all during a migraine, and may present with stomach pain, vomiting, or dizziness.1 

Although headaches in children and adolescents may be common, they are not normal. Most headaches in children are not due to serious underlying problems, however can still be upsetting for the child and may impact schooling, sport and play activities.1 

Causes of headaches in children

Common causes of headaches in children include knocks and falls, dehydration, missing meals, poor diet, lack of sleep, stress, eye problems, sinus and nasal congestion, illness, post dental work or post-operations under general anaesthetic.1 Often with the addition of poor posture, text neck, increased screen time as children grow into their adolescent years. Causes of headache in infants may be due to traumatic, non-traumatic or instrument assisted births.5

Headaches caused by serious underlying pathologies are uncommon and will often present with other more concerning signs and symptoms such as paralysis, drowsiness or loss of consciousness.6 

All reoccurring headaches in children should be investigated by a healthcare worker. It is important to see a healthcare worker if:

  • Your child has a new headache that is getting worse
  • The headache is more frequent than once a week
  • Your child wakes at night in pain from the headache or it is worse in the morning
  • The headache is associated with vision changes, vomiting or fevers
  • The headache begins to disrupt your child’s school, home or social life1

References:

  1. The Royal Children’s Hospital Melbourne. Kids health information: Headaches [Internet]. 2018 May [cited 2022 Mar 3]. Available: https://www.rch.org.au/kidsinfo/fact_sheets/Headaches/
  2. King NJ, Sharpley CF. Headache activity in children and adolescents. J Paedtr Child Health. 1990 Feb; 26(1):50-54. Available: https://doi.org/10.1111/j.1440-1754.1990.tb02379.x 
  3. Strine TW, Okoro CA, McGuire LC, Balluz LS. Difficulties, and health care use: The association among childhood headaches, emotional and behavioural. Pediatrics. 2006 Jun; 117:1728-1735.Available: https://doi.org/10.1542/peds.2005-1024 
  4. Pogliani L, Spiri D, Penagini F, Di Nello F, Duca P, Zuccotti G. Headache in children and adolescents aged 6-18 years in Northern Italy: Prevalence and risk factors. Eur J Paediatr Neurol. 2011 May; 15(3):234-240. Available: https://doi.org/10.1016/j.ejpn.2010.11.005 
  5. Barham-Floreani J, Marshall K. 5 key questions about headaches in children [Internet]. 2011 Nov [cited 2022 Mar 3]. Available: https://welladjusted.co/parenting/headaches-in-children/ 
  6. Brna PM, Dooley JM. Headaches in the pediatric population. Semin Pediatr Neurol. 2006 Dec; 13(4):222-230. Available: https://doi.org/10.1016/j.spen.2006.09.003 

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