Diagnosis is made usually after a detailed history taking and physical examination. The doctor may order neuroimaging such as Computerised Tomography (CT) scan or Magnetic Resonance Imaging (MRI) if clinically indicated.
Treatment principles for primary headaches include using painkillers when needed and minimising triggers such as psychological stress, sleep deprivation and prolonged screen time.
Analgesics, also known as painkillers, such as paracetamol and Non-Steroidal Anti-Inflammatory Drugs can be used when your child is experiencing an acute severe headache (tension type headache and migraine). However, painkillers should not be given more than 2 days per week to avoid the risk of medication-overuse headache.
Prophylactic therapy is a type of preventive treatment used when migraines occur frequently or have significant adverse impact on your child's life. A doctor will discuss the effectiveness and possible complications of the medications with you before starting the prophylactic treatment.
Treatment for chronic headaches requires a holistic approach over several months with the aim of your child returning to normal activities. The specific measures include:
- Giving headache medication only as directed by your doctor. Excessive use of painkillers can lead to rebound headaches (medication-overuse headaches).
- Identifying and avoiding headache triggers, and addressing sources of stress (including exams and menstrual cycle), mood or anxiety problems. Counselling or psychotherapy sessions may be required.
- Maintaining a regular sleep/wake cycle. Ensure that your child gets at least 8 to 10 hours of undisturbed sleep at night.
- Eating regular and nutritious meals. Do eat regular healthy meals that include carbohydrates, protein, fruits and vegetables. Avoid MSG in your child's meals as it can trigger headaches.
- Drinking plenty of water. Dehydration can lead to headaches as well.
- Avoiding caffeine and alcohol. Caffeine is a stimulant; when levels of caffeine in the blood decrease, headaches increase. Alcohol can be a trigger of headaches.
- Exercising. Exercise can increase blood flow and endorphins to your child's brains, helping to reduce stress and keep your child physically fit.
- Keeping a headache diary. This will help you and your doctor to track your child's progress.
- Relaxing. Take some time off your child's busy schedule to pursue a hobby or to do a relaxing activity.
- Having realistic expectations. The frequency and severity of the headaches may decrease over weeks to months of treatment but they may not completely disappear.
The treatment for secondary causes of headaches will depend on the underlying cause.