Migraine and other causes of headache in childrenHeadache is a very common complaint among children brought to a pediatrician. There are several causes of headache. Usually it is not due to any serious disease. However persistent headache should not be taken lightly because of possibility of tumors inside the head. Headache can be caused by excessive muscle contraction, dilation of blood vessels, inflammatory conditions and due to increased intra-cranial pressure. Migraine is known to occur in any age though it is not easy to identify it in young children. Headache due to migraine is recurrent and occurs in paroxysms. In between attacks child remains normal. No abnormality of the nervous system can be detected on thorough clinical examination. The affected child’s growth and development will be within normal limits. In majority of affected children there will be positive family history of migraine headache. The pain may be felt on one or both sides of head. It is usually experienced over the region on the frontal or temporal bone. Sometimes the pain may be felt behind the eyes or over the cheek regions. The pain has a pulsatile quality. The pain usually lasts for about 2 hours though occasionally it may last for more than 24 hrs. In some patients an attack may be precipitated by lack of sleep, specific foods or irregular eating habits but usually no such factor can be identified. Other symptoms like nausea, vomiting, dizziness, intolerance to bright light or loud noise may accompany headache. Unusual manifestations are transient loss of speech, weakness of one side of body, confusion and distorted visual perception (Alice in wonderland syndrome). Laboratory tests and scanning (C T and MRI) are normal in this condition. These tests are often done to rule out other condition when there is doubt. Treatment: Analgesics (drugs which decrease pain) should be given as soon as pain starts. Ibuprofen can be given in a dose of 10 mg per kilogram of body weight and another dose of 5mg per kg if needed may be given after 45 minutes.
Page last reviewed on 21th February 2010
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