HEADACHE
Symptom Definition
- Pain or discomfort of the scalp or forehead areas.
- The face and ears are excluded.
Causes
- Viral illnesses: Most headaches are part of a viral illness, especially with colds. These usually last a few days
- Muscle tension headaches: Most common type of recurrent headaches
- Migraine headaches: Recurrent severe, incapacitating headaches
- Other common causes: Hunger, exertion, sunlight
- Serious causes: Meningitis or encephalitis
See More Appropriate Topic(instead of this one) If
- Followed a head injury within last 3 days, see HEAD INJURY.
- Pain is around the eye or the cheekbone, see SINUS PAIN AND CONGESTION.
WHEN TO CALL YOUR DOCTOR
Call 911 now (your child may need an ambulance)if:
- Difficult to awaken or passed out.
- Confused thinking/talking or slurred speech.
- Blurred or double vision.
- Weakness of arm or leg or unsteady walking.
Call your doctor now (night or day) if:
- Your child looks or acts very sick
- Stiff neck (can't touch chin to chest)
- Severe headache
- Vomiting
Call your doctor within 24 hours (between 9am and 4pm) if:
- You think your child needs to be seen
- Fever
- Sinus pain (not just congestion)
Call your doctor during weekday office hours if:
- You have other questions or concerns
- Headache without other symptoms present over 24 hours
- Sore throat present over 48 hours
- Any headache present for more than 3 days
- Headaches are a recurrent ongoing problem
Parent care at home if:
- Mild headache and you don't think your child needs to be seen.
HOME CARE ADVICE
- Pain Medicine: Give acetaminophen (e.g. Tylenol) or ibuprofen for pain relief (see Dosage table). Headaches due to fever are also helped by fever reduction.
- Food: Give fruit juice or food if your child is hungry or hasn't eaten in more than 4 hours (reason: skipping a meal can cause a headache in many children).
- Rest: Lie down in a quiet place and relax until feeling better.
- Local Cold: Apply a cold washcloth or ice pack to the forehead for 20 minutes.
- Stretching: Stretch and massage any tight neck muscles.
- Migraine Headaches Diagnosed in the Past: If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts. If not, ibuprofen is the best OTC drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table). Also, have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone
- Call Your Doctor If:
- Headache becomes severe
- Isolated headache lasts over 24 hours
- Headache lasts for more than 3 days despite using a pain medicine
- Your child becomes worse
Treatment for Migraine Headache
- Reassurance: This headache is similar to previous migraine headaches that your child has experienced.
- Migraine Medication:
- If your child's doctor has prescribed a specific medication for migraine, give it as directed as soon as the migraine starts.
- If not, ibuprofen is the best over-the-counter drug for migraine. Give ibuprofen now and repeat in 6 hours if needed (See Dosage Table).
- Sleep: Have your child lie down in a dark, quiet place and try to fall asleep. People with migraine often awaken from sleep with their migraine gone.
- Call Your Doctor If:
- Headache become much worse than usual
- Headache lasts longer than usual
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Elser JM. Easing the pain of childhood headaches. Contemp Pediatr. 1991 Nov; 8:108-123.
- Feign RD, et al. Diagnosis and management of meningitis. Pediatr Infect Dis J. 1992;1:785-814.
- Fisher PG. Help for headaches. Contemp Pediatr. 2005;22(11):34-40.
- Forsyth R, Farrell K. Headache in childhood. Pediatr Rev. 1999;20:39-45.
- Gabis LV, Yangala R, Lenn NJ. Time lag to diagnosis of stroke in children. Pediatrics. 2002;110:924-928.
- Lewis D. Pediatric migraine. Pediatr Rev. 2007;28(2):43-52.
- Lewis DW, Qureshi FA. Acute headache in the pediatric emergency department. Headache. 2000;40:200-203.
- Molofsky WJ. Managing stroke in children. Pediatr Ann. 2006;35(5):379-384.
- Molofsky WJ. Headaches in children. Pediatr Ann. 1998;27:614-621.
- Rubin D, Suecoff S, Knupp K. Headaches in children. Pediatr Ann. 2006;35(5):345-353.
- Singer HS and Rowe S. Chronic, recurrent headaches in children. Pediatr Ann. 1992;21(6):369-73.
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.
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