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  • Headache

    Definition

    • Pain or discomfort of the head
    • This includes the forehead to the back of the head
    • Not caused by a head injury

    Causes

    • Viral illnesses. Most headaches are part of a viral illness, especially with colds. Most often, these last a few days.
    • Muscle tension headaches. Most common type of frequent headaches. Muscle tension headaches give a feeling of tightness around the head. The neck muscles also become sore and tight. Tension headaches can be caused by staying in one position for a long time. This can happen when reading or using a computer. Other children get tension headaches as a reaction to stress or worry. Examples of stress in children are pressure for better grades or family arguments.
    • Migraine headaches. Severe, very painful headaches that keep your child from doing normal activities. They are throbbing and often occur on one side. Vomiting or nausea are present in 80%. Lights and sound make them worse. Most children want to lie down in a dark, quiet room. Will recur.
    • Other common causes. Hunger, hard work or sports, sunlight, coughing.
    • Frontal sinusitis. Can cause a frontal headache just above the eyebrow. Rare before 10 years old because frontal sinus not formed yet. Other sinuses cause face pain, not headache.
    • Serious causes. Meningitis or encephalitis. Symptoms include a headache, stiff neck, vomiting, fever and confusion.

    Pain Scale

    • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: The pain is very bad. It keeps your child from doing all normal activities.

    When to Call Us for Headache

    Call 911 Now (your child may need an ambulance) If:

    • Hard to wake up or passed out
    • Acts or talks confused
    • Weakness of arm or leg
    • Walking not steady
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Stiff neck and can’t touch chin to chest
    • Severe headache
    • Vomiting
    • Blurred vision OR seeing double
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Fever
    • Sinus pain (not just congestion) of forehead

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Headache without other symptoms lasts more than 24 hours
    • Sore throat lasts more than 48 hours
    • Any headache lasts more than 3 days
    • Headaches are a frequent problem

    Parent Care at Home If:

    • Mild headache
    • Migraine headache, just like past ones

    Care Advice for Headaches

    Treatment for Mild Headache

    What You Should Know:

    • Headaches are very common with some viral illnesses. Most often, these will go away in 2 or 3 days.
    • Unexplained headaches can occur in children, just as they do in adults. They usually pass in a few hours or last up to a day.
    • Most headaches (including muscle tension headaches) are helped by the following measures.
    • Here is some care advice that should help.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
    • Headaches due to fever are also helped by bringing the fever down.

    Food:

    • Give fruit juice or food if your child is hungry.
    • If your child hasn’t eaten in more than 4 hours, offer some food.
    • Reason: Skipping a meal can cause a headache in many children.

    Rest:

    • Lie down in a quiet place and relax until feeling better.

    Cold Pack:

    • Put a cold pack or a cold wet washcloth on the forehead.
    • Do this for 20 minutes.

    Stretching:

    • Stretch and rub any tight neck muscles.

    Call Your Doctor If:

    • Headache becomes severe
    • Vomiting occurs
    • Headache without other symptoms lasts more than 24 hours
    • Headache lasts more than 3 days
    • Your child becomes worse

    Extra Advice – Muscle Tension Headache Prevention:

    • If something bothers your child, help him talk about it. Help him get it off his mind.
    • Teach your child to take breaks when he is doing school work. Help your child to relax during these breaks.
    • Teach your child the importance of getting enough sleep.
    • Some children may feel pressure to achieve more. This may cause headaches. If this is the case with your child, help him find a better balance.
    • Caution: Frequent headaches are often caused by too much stress or worry. To be sure, get your child a medical checkup first.

    Treatment for Migraine Headache

    What You Should Know:

    • This headache is like the migraine headaches that your child has had before.
    • Here is some care advice that should help.

    Migraine Medicine:

    • If your child’s doctor has prescribed a medicine for migraines, use it as directed. Give it as soon as the migraine starts.
    • If not, ibuprofen is the best over-the-counter drug for migraines. Give ibuprofen now. Repeat in 6 hours if needed. See Dose Table.

    Sleep:

    • Have your child lie down in a dark, quiet place.
    • Try to fall asleep.
    • People with a migraine often wake up from sleep with their migraine gone.

    Prevention of Migraine Attacks:

    • Drink lots of fluids.
    • Don’t skip meals.
    • Get enough sleep each night.

    Call Your Doctor If:

    • Headache becomes much worse than past migraines
    • Headache lasts longer than past migraines

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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