{"id":16843,"date":"2022-05-10T11:49:52","date_gmt":"2022-05-10T09:49:52","guid":{"rendered":"https:\/\/neurologiaclinica.es\/neurological-diseases-and-disorders\/headaches-in-children-and-adolescents\/"},"modified":"2025-04-28T22:26:35","modified_gmt":"2025-04-28T20:26:35","slug":"headaches-in-children-and-adolescents","status":"publish","type":"page","link":"https:\/\/neurologiaclinica.es\/en\/neurological-diseases-and-disorders\/headaches-in-children-and-adolescents\/","title":{"rendered":"Headaches in children and adolescents"},"content":{"rendered":"\t\t
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Headaches in children and adolescents<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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GENERAL ASPECTS<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Are headaches common in children and adolescents?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Headache<\/strong> is one of the most frequent reasons for neurological consultation among children and adolescents. It is estimated that between 5 and 17 years of age, 20% present headaches. The prevalence of tension-type headaches in children and adolescents has been estimated to be highly variable. It is likely to be present in 15-20%. It is estimated that at 10 years of age, 5% of children have headaches compatible with migraine. In childhood it affects both sexes equally. In adolescence it is three times more frequent in the female sex. Cases in which the headache is due to a serious illness are rare. However, this possibility should be excluded by a physician. Many headaches that appear in childhood and adolescence are related to stress and inadequate lifestyle<\/strong>. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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What types of headaches can occur in children and adolescents?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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The possible causes of headaches are many. The International Headache Society (IHS) classifies more than 150 different types of headaches. The most frequent are the following:<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • Migraine<\/li><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    It is characterized by episodic severe headaches<\/strong>. During the painful episodes there is special sensitivity to light and noises. They are frequently accompanied by nausea and vomiting. The presence of nausea in children with headache is very suggestive of migraine<\/strong>. In children the headache may last less time than in adults. Sometimes it may subside in a little more than two hours. Most children and adolescents have bilateral headache.<\/strong> It is a cause of absence from school and difficulty for the adequate school performance. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • Tension headache<\/li><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    They are episodic headaches<\/strong> that are not as disabling as migraine. They are also not accompanied by other symptoms such as sensitivity to light and noise, nausea and vomiting. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • Mixed headache<\/li><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    They consist of a combination of migraine-type headaches and tension-type headaches<\/strong>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • Persistent daily headache<\/li><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    It is a daily headache<\/strong> that begins with no known apparent cause and continues without cessation for at least three months. The type of headache may resemble migraine or tension headache. It is a clinical picture that may have different causes<\/strong>. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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  • Idiopathic stabbing headache<\/li><\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    It is more frequent in children under 6 years of age<\/strong>. It is characterized by brief attacks of sharp stabbing pain. The duration is usually a few seconds, although some children may have attacks lasting minutes. Sometimes it can become very intense<\/strong>. The location of the pain may be fixed or changing. <\/p>

    Other times headaches may be due to specific demonstrable causes(secondary headaches<\/strong>). These would include common possibilities such as common childhood viral infections, sinusitis or otitis. More rarely, the headache may be due to meningitis, encephalitis, hemorrhage, tumor, or other serious illness. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    DIAGNOSIS<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    When to consult for a headache?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    A severe headache of sudden onset<\/strong> makes it necessary to go to the emergency room of a hospital to exclude a serious illness. In such cases, an urgent medical assessment should be carried out and the necessary tests decided. Blood tests and neuroimaging will be considered.<\/strong> It may be necessary to perform a lumbar puncture to analyze the CSF. A neurological assessment should be performed. Most commonly, headaches are more gradual in onset, recurrent or insidious in course. In these cases, a neurological consultation is advisable.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    What is the medical evaluation of a child or adolescent with headache?\n<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    The physician’s first objective is to be able to identify the few children and adolescents who have a responsible cause of headaches<\/strong> (secondary headaches) from the majority who will not have an identifiable responsible cause (primary headaches), such as migraine. Clinical assessment (detailed medical history and complete neurological examination) is usually sufficient to distinguish between the two groups of headaches mentioned (primary headaches and secondary headaches). However, in some cases it is necessary to resort to blood tests, head imaging studies (neuroimaging), cerebrospinal fluid (CSF) analysis or other tests to clarify the situation. It isimportant to be able to identify the alarm criteria<\/strong> for secondary headaches, to identify the diagnostic features of primary headaches, the need or not to perform complementary studies and to recommend the appropriate treatment for each case. Sometimes an ophthalmologic or otorhinolaryngologic (ENT) evaluation may be necessary. If the possibility of stress or an emotional cause is considered, a psychological or psychiatric<\/strong> evaluation should be considered .<\/strong> <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    TREATMENT<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    How is a headache in children and adolescents treated?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    In the case of a migraine headache<\/strong>, it is advisable to rest in a quiet and dark place. It is good to hydrate yourself<\/strong> by drinking repeated sips of water. If it is possible to go to sleep, it is advisable. It is frequent that the pain disappears<\/strong> after having slept a few hours. Pharmacological treatment of migraine attacks in children and adolescents includes paracetamol and non-steroidal anti-inflammatory drugs<\/strong> (ibuprofen, naproxen). In older children and adolescents triptans<\/strong> (sumatriptan, rizatriptan, zolmitriptan, almotriptan) are useful. The pharmacological treatment<\/strong> indicated in the case of tension headaches includes paracetamol and non-steroidal anti-inflammatory drugs (ibuprofen, naproxen). <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    What non-pharmacological measures are useful for the prevention of migraine headaches in childhood and adolescence?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    An orderly lifestyle<\/strong> is beneficial in children and adolescents with migraine. In adolescence it is difficult to adjust certain habits considering the physical, cognitive and emotional changes that occur. It is positive that the physician explains well to children and adolescents, and their relatives, the convenient lifestyle habits to try to reduce the frequency of headaches<\/strong>. <\/p>

    It is advisable to sleep the appropriate number of hours, which varies depending on age. Between 3-5 years it is advisable to sleep 10-13 hours a day, between 6-12 years 9-12 hours a day, and between 13-18 years 8-10 hours a day. It is also appropriate to maintain a constant sleep rhythm<\/strong>, including weekends. In adolescence it is especially difficult to follow these indications. <\/p>

    Drinking plenty of fluids<\/strong> may help improve headaches.<\/p>

    In relation to food, it is necessary to eat three meals a day<\/strong>, avoiding prolonged periods of fasting. For some adolescents the problem is lack of time or lack of appetite early in the morning to eat breakfast properly. In these cases it may be convenient to have breakfast prepared (e.g. fruit, cheese) to take with them. <\/p>

    Coffee should not be drunk during childhood<\/strong> and excessive consumption should be avoided during adolescence. The maximum recommended is two cups of coffee a day. It is not convenient to change the frequency of its use, especially on weekends. <\/p>

    Continuous<\/strong>, gentle, aerobic physical exercise<\/strong> several times a week has been shown to be useful in prevention. Sometimes physical exercise can facilitate migraine attacks. <\/p>

    Cognitive-behavioral therapy<\/strong>is a type of psychological treatment (psychotherapy) that, together with lifestyle adjustments, has been shown to be effective in reducing headaches. The treatment consists of a limited number of sessions. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    GENERAL ASPECTS Are headaches common in children and adolescents? Headache is one of the most frequent reasons for neurological consultation among children and adolescents. It is estimated that between 5 and 17 years of age, 20% present headaches. The prevalence of tension-type headaches in children and adolescents has been estimated to be highly variable. It […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":16593,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-16843","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/pages\/16843","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/comments?post=16843"}],"version-history":[{"count":4,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/pages\/16843\/revisions"}],"predecessor-version":[{"id":17952,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/pages\/16843\/revisions\/17952"}],"up":[{"embeddable":true,"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/pages\/16593"}],"wp:attachment":[{"href":"https:\/\/neurologiaclinica.es\/en\/wp-json\/wp\/v2\/media?parent=16843"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}