Migraines & Headaches

Types of headaches include:

• Migraine
• Chronic tension headache
• New daily persistent headache
• Headaches that are symptoms of other medical conditions

Chronic tension headaches are the most common type of headache in children that leads to medical evaluation.

Typical tension headache symptoms include:

• Slow onset of pain
• Head pain on both sides
• Pain is mild to moderate
• Pain may affect the back of the neck

Migraine headaches may follow four phases:

• Premonition phase. Your child may show a change in mood or behavior.
• Aura phase. Your child may experience unusual feelings before a migraine headache, such as visual changes, numbness and tingling and trouble pronouncing words.
• Headache phase. Your child will feel moderate to severe (but often throbbing) pain on one or both sides of the head. The pain may last several hours. During this phase, your child may be sensitive to light and sound, experience nausea and vomiting and avoid movement or activity,
• Headache resolution phase. After the headache pain goes away, your child will likely feel exhausted and weak.

Symptoms vary for other headache types.

Although headaches are not often medically harmful, they can cause your child to miss school and other activities. Frequent and recurring headaches are also associated with anxiety, depression and sleep disorders.

Diagnosis of Migraines & Headaches

The first step is to rule out any underlying medical issues that may be causing the headaches. Next, your child’s doctor will ask about certain headache triggers, such as lack of sleep or poor diet. The doctor will also ask a series of questions to pinpoint the specific type of headache causing your child's pain. This will be followed by a physical exam.

In most patients with headache disorders, medical tests are unable to determine the specific cause of the headaches. If there is concern that the headaches may be due to an underlying medical condition based on their description or a physical exam finding, further testing may include:

• Lab tests. Your child's doctor may run a variety of tests to rule out other conditions or diagnose the cause of headaches. Lab tests include:
  • Blood test. Blood tests check for anemia, thyroid disorders and other imbalances of vitamins and electrolytes, which can contribute to headaches.
  • Lumbar puncture. This test checks the spinal fluid that surrounds the brain and spinal cord.
• Magnetic resonance imaging (MRI). A MRI scan uses powerful magnets to create detailed pictures of the brain.