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The start of the school year is just around the corner, and we frequently see an increase in calls regarding headaches around this time. We want to take this opportunity to review some basic steps in diagnosing and treating headaches. Nearly 10 percent of children have frequent or recurrent headaches. While this is a significant source of parental anxiety, the vast majority are benign and easily manageable by their primary care provider.
Tension type is the most common type of headache during childhood. Children report mild to moderate pain, usually do not have nausea or vomiting and they can typically continue normal activities.
Migraines are also quite common. The pain may be described as severe, throbbing and associated with nausea, vomiting, dizziness and sensitivity to light and sound. They may report visual changes before or during the headache, and they usually prefer to stop activities and lay down in a dark, quiet place.
The increase in headaches as the school year starts may be for a variety of reasons, many of which are treatable with lifestyle modifications:
Helpful handouts from Cook Children's:
Lifestyle reminders for migraine patients
Sleep habit guidelines
While most headaches are benign, some symptoms warrant further investigation, including those that:
LEARN MORE: Recent abstract presentation on ketamine use for acute migraine treatment
If worrisome features are present, the primary care physician should consider ordering neuroimaging, preferably an MRI.
If a child needs analgesics consistently >three times per week in spite of adherence to lifestyle recommendations, he or she may be a good candidate for a neurology evaluation. The Cook Children’s Comprehensive Headache Program, led by Brian Ryals, M.D., offers a multifaceted approach to treatment, including medication, biofeedback, Botox and nerve blocks.
Comprehensive Headache Program
Dr. Brian Ryals
If you would like to schedule an appointment, refer a patient or speak to our staff regarding your child's headaches, please call our offices at 682-885-2500.