At one time or another, almost all children complain of a headache. In fact, the three most common recurring pain symptoms that pediatricians see are abdominal pain, chest pain, and headaches.
While a sudden severe headache may suggest a serious problem within the head or central nervous system and require prompt evaluation, headaches are most often a symptom of other medical or emotional problems. Your child may be feeling stress and tension. Or she may have a cold, the flu, or strep throat. Sometimes fevers and headaches occur at the same time, so if your child complains of head pain, check her temperature.
Some children experience a recurrent headache called migraine, which can begin in childhood. Unlike headaches caused by tension, these are often accompanied by other symptoms. Children may have a premonition that they will occur. Often, the headache occurs along with nausea, vomiting, or visual disturbances. The head pain itself is typically throbbing or stabbing and may affect one or both sides of the front part of the head. There may also be other unpleasant sensations in the head, including burning, tingling, aching, or squeezing. The child may prefer a darkened room. Migraines tend to run in families.
Migraine pain is cause by chemicals produced in the brain that alter blood vessels in the brain. (By comparison, stress headaches are characterized by a contraction of the muscles at the back of the head.) The head pain typically lasts for several hours or even overnight.
In diagnosing your child's headache you pediatrician will look for an underlying disease or condition. For most types of headaches, rest and some pain medication like acetaminophen on nonsteroidal anti-inflammatory drugs may be all that is necessary, along with treatment of the primary disorder. Depending on the type of headache, your doctor might also recommend prescription drugs or stress-management techniques. If migraines occur more than two to three times a month-and particularly if they interfere with attending or functioning well in school-your doctor may prescribe medication as a preventive measure. A number of oral and nasal drugs that can control the attack are now available for older children. The doctor may also suggest some counseling to explore whether emotional factors may be contributing to the headaches. Headaches should not be allowed to control home or school activities.