Headaches in children: A systematic approach


Headaches are common among childhood and adolescence. Though they are a cause for concern among parents, fortunately most headaches are benign.
Primary headaches are tension type headaches, migraine or cluster headache.Most common types of headaches in children are tension type headaches and migraine.Secondary headaches are due to any brain problem or other medical conditions in the body.
Tension type headache:

  • Triggered by stress
  • Non pulsating, on both sides of the head
  • Tightness in head and neck muscles.

Migraine :

  • Moderate to severe headache which last for 2 to 48 hours,may be preceded by an aura ie, seeing flashes or lines.
  • Pulsating or throbbing pain
  • Associated with nausea,vomiting and abdominal pain
  • Sensitivity to light and sound

Cluster headache :

  • Painful headaches lasting for weeks or months.
  • Stabbing pain on one side of head
  • Accompanied by watery and red eyes, runny nose

When to see a doctor for headache?

  • Interferes with child’s sleep.
  • Accompanied by persistent vomiting and changes in vision.
  • Becomes frequent.
  • Associated with fever or stiffness in neck.
  • Slurred speech, confusion.
Other medical conditions causing headache:
  • Fever,cold,sinus or ear infections
  • Uncorrected shortsigtedness , near sightedness or astigmatism
  • Head injuries
  • Increased pressure in brain
  • Changes in blood sugar ,sodium and pottassium.
  • Meningitis,encephalitis
  • Brain tumours


Sometimes an MRI or CT scan is needed to further probe the causes of headache.
Treatment of headaches in children
Medications are needed for the relief of primary type of headache.There are three groups.
  • Symptomatic relief– For relief of pain, nausea and vomiting. Some examples are acetaminophen,ibuprofen and domperidone.Be cautious of overusing these medicines as it can lead to frequent episodes and rebound headaches.
  • Abortive therapy– For preventing progression of migraine headaches.Example is triptan group of drugs
  • Preventive therapy– To prevent further episodes.Examples are calcium channel blockers,beta blockers,antidepressants and anticonvulsants.

Secondary headaches are managed by treating the cause.

Practices preventing headaches.
  • Reduce stress
  • Get enough sleep ,8 hours daily
  • Take adequate quantity of water and cut down caffiene.
  • Reduce screen time

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