Headaches In Children
Headaches are very common problems in children. Fortunately, most headaches are not a sign of a serious condition. But many people believe that headaches are commonly caused by a need for glasses or improper glasses. Actually, headaches are usually caused by other problems. Eyestrain and vision problems are not common causes of headaches.
Children’s headaches are often caused by one of the following:
• Tension
• Migraine
• Diseases of the head, eyes, ears, teeth, etc.
Tension Headaches
Tension headaches (muscle contraction headaches) are usually caused by excessive tension in the muscles in the neck, jaw or other muscles in the head area. Often, stress is a contributing factor, but these headaches can also be caused by abnormal sleeping positions, jaw clenching, long periods of close work with sustained neck contraction or even excessive gum chewing. Changes in these types of activities may be helpful, or other-the-counter pain medications such as ibuprofen can give relief. The pain itself may be felt in the head, neck or forehead, making diagnosis somewhat difficult and confusing.
Migraine Headaches
Migraines are a very common and underdiagnosed condition, particularly in children. About 1 in 10 people suffer from migraines. Migraines are NOT simply a severe headache but a combination of symptoms that may present in a very confusing fashion. A classic migraine begins with visual changes called a visual aura that may include moving jagged lines, decrease or loss of vision in one or both eyes or decreased vision to one side. Children often complain of blurred vision that occurs sometime but not all of the time. In classic migraines, the visual aura is followed by a headache that often occurs on one side of the head and is following by nausea, vomiting or a period of weakness in which the child may need to lay down and avoid bright lights.
Migraines in children often do not follow the classic pattern. The child may simply report visual changes or blurring and may not have a headache following the visual changes. The headaches may occur at completely different times unrelated to the visual changes. Usually the headaches occur in cycles; that is, the child will have a period in which the headaches occur quite frequently, even daily, followed by a long period without headaches. Then often, without warning, the headaches begin again. Glasses prescribed during the periods of headaches may mistakenly be felt to cure the headaches.
There are many triggers that may precipitate headaches, such as stress, irregular sleep patterns and foods (like chocolate or cheese). Women often get migraines from pregnancy or birth control pills.
Migraine treatment depends of the severity. Ibuprofen is often effective. Excedrin Migraine is also an excellent drug. There is one class of drugs designed to treat migraine when given at the onset of the headaches (e.g. Imitrex) and another entire class of drugs (such as Inderal or Periactin, an antihistamine) that can be used to prevent the headaches from occurring at all.
Diseases as a Cause of Headaches
Headaches caused by eye disease in children are usually accompanied by pain in or around the eye; redness; or swelling of the eye itself. Headaches caused by a brain tumor are actually quite rare. Such headaches usually increase in intensity over time and may change with alterations in body position. Other neurological signs such as weakness, tingling, numbness or seizures may be present. Your primary care doctor may ask your child to have an eye exam to determine whether excessive pressure is present in the brain. This will involve dilating your children’s eyes and viewing directly the optic nerve, which is directly connected to the brain.
Sinus problems can cause headaches, but many people who ascribe their headaches to sinus problems actually have migraines. Almost always, sinus problems that cause headaches will be associated with stuffiness of the nose and sinuses.
Eyestrain and Headaches
Contrary to popular conception, the need for glasses or improper glasses is not a leading cause of headaches. Usually, poorly prescribed glasses simply cause blurred vision: your children may remove the glasses or look over them. Eye muscle problems that cause difficulty focusing the eyes together can cause headaches, and glasses that are too strong may induce excessive focusing that can result in headaches.
A complete eye exam, which includes evaluating the eye muscle system; determining the possible need for glasses; an examination of the pupils and optic nerve; and taking a thorough medical history, can be very helpful in pinpointing the cause of headaches. All of these measures can lead to proper treatment and relief from this very common problem.
