Headache is a common complaint in children with up to 75 per cent reporting at least one notable headache by the age of 15. Here The Portland Hospital experts offer their tips for getting to the root cause of headaches.
Although most headaches in children are not due to a serious underlying condition, they can affect their lives by interfering with school and other daily activities.
‘Common triggers for such headaches can include skipping meals, dehydration following sporting activities or not taking enough fluids, emotional stress and anxiety, allergy to certain foods or food additives and beverages and irregular sleep patterns,’ says Dr Dion Alexandrou, Consultant Paediatrician at The Portland Hospital.
‘Infections such as the common cold and flu, ear and throat infections are also possible causes. These can be treated by addressing simple lifestyle issues, using painkillers, tackling stress and treating infections accordingly.’
TYPES OF HEADACHE
There are two broad categories of headache: primary headache – a headache without a significant underlying cause - and secondary headache, which is a symptom of an underlying serious problem. Migraine and tension headaches fall into the primary headache category.
‘Tension-type headaches tend to be featureless and milder, and the child can continue normal activities, in contrast to migraine,’ says Dr Alexandrou. ‘Tension headaches tend to occur during times of stress. They involve the neck and the back of the head, there is no sickness, vomiting or abdominal pain, and no family history of headaches.
‘Children are under a lot of pressure to succeed at school these days and exam season can be particularly stressful. Bullying at school may be another cause. They also pick up on relationship problems within the family, loss of a loved one and financial worries.’ If the headaches are not severe enough to affect the child’s daily activities, Dr Alexandrou usually talks to the family about what is going on in their child’s life and suggests making adjustments if necessary. If the child’s headaches are more severe and stopping them from going to school or socialising, a referral to a psychologist may be advised.
‘Migraine is a very bad headache. It is unpleasant but not dangerous and we don’t know why some people get them,’ says Dr Alexandrou. The main difference from an ordinary headache is that migraine can last a long time and it might only go when you sleep.
You may also feel worse if you try to do anything, sick, light or sound may hurt your head and you may need to lie down in a dark room. Different people have different triggers and some people have warning signs before they get a migraine.
‘Triggers can include light, noise, sleep disruption, changes in routine and even some foods including cheese and Dr Alexandrou.
If you get migraines as a child, there’s more than a 50 per cent chance they will stop when you reach puberty.
However, if you start getting migraines as a teenager, they will probably continue into adulthood (although migraines tend to be not as bad as people get older).
Headaches can sometimes be related to eye strain from staring at a screen too long – and computer screens, tablets and phones can all have this effect.
‘This is caused by the eye blinking less so the muscle gets tired and the surface of the eye gets dry,’ says Consultant Ophthalmologist Jane Leitch, who practises at the Portland and the Epsom and St Helier NHS Trust. ‘Some children will also develop headaches when they try to see the blackboard – they may be short-sighted and need to wear glasses to correct their vision.
‘Most children are given a routine eye test between the ages of 4 and 5 and some of these problems can be picked up then. ‘Distorted vision can be associated with migraines. Sudden onset double vision is rare, it can be an indication of pressure in the brain causing changes at the back of the eye which need urgent investigation.’
RED FLAG SYMPTOMS
- If a child’s headache gets worse when they bend forward or when coughing and straining, or it wakes the child (as opposed to the headache being present on awakening) it could be a sign of a more serious underlying problem.
- Other red flag symptoms include morning or persistent sickness and vomiting, recent change in personality or behaviour, gait and balance problems and visual disturbances (double vision).
- ‘Acute onset of severe headache associated with high temperature and neck stiffness and fear of lights (photophobia), is particularly worrying and most likely due to severe infection, most notably meningitis, and the child should go to Accident and Emergency immediately,’ says Dr Alexandrou.
- ‘Most of the children I see as a paediatrician suffer from tension-type headaches, followed by occasional migraine headaches and extremely rarely headaches accompanied by neurological symptoms and signs due to brain tumours or bleeds.’
- ‘All parents fear the worst when their child complains of a headache but thankfully serious conditions such as brain tumours and meningitis are rare.’