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A headache occurs when one experiences a sharp pain, throbbing sensation or a dull ache in any part of the head. The pain may be at one or both sides of the head, only at a certain point or throughout the whole head.A headache can happen anytime or develop gradually. It may last from less than an hour to several days.Headaches are common in children and adolescents. It is one of the frequently cited reasons for clinic and emergency department visits. The prevalence ranges from 17% to 90% of children. Headaches are more common in boys than girls before puberty but the ratio changes after they go through puberty.
Headaches in children and adolescents may be due to a primary headache syndrome or are secondary to underlying medical conditions.
The common primary causes include tension type headache, migraine, cluster headache and chronic daily headache.
Secondary headaches may provide a clue to a serious underlying condition that requires prompt intervention. The secondary causes are usually related to a virus infection with fever but may be due to rare causes such as:
Parents should look out for signs and symptoms suggestive of secondary causes of headaches. These include:
Any headache which is getting more frequent or severe will warrant medical attention.
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:
The treatment for secondary causes of headaches will depend on the underlying cause.
Go to the Children's Emergency immediately if your child is experiencing any of these symptoms:
Headaches can be improved by avoiding the triggers, exercising, sleeping well and seeking proper treatment from a doctor.