How common are headaches in children?

Over 1 million American children & adolescents suffer from headaches that impact on their daily lives, social development and future potential. 1% of children less than 10 years of age and 4 - 5% of children 10 - 17 years of age suffer from frequent and/or severe headaches. According to an 1989 National Health Interview Survey in the U.S., headaches ranked as the third leading cause of school absence.

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What kind of headaches do children do children usually have? Children suffer from the same kind of headaches that afflict adults - migraine, tension type and chronic daily headaches. Migraines are the most under diagnosed headache in children and adolescents. The first episode of migraine usually occurs between 6 - 25 years of age and may begin as early as 2 years. The incidence of migraine is between 4% in children under 12 years of age and increases to 6 - 18% by late adolescence. Pre-puberty, the ratio of migraine females to males is 1:1, following puberty the ratio of females to males with migraine increases to 3:1.

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Can headaches be caused by a serious condition?

Headaches secondary to an underlying disease are not common in children, but do need to be ruled out. These include hydrocephalus, brain tumor, infections and trauma. The headache should be investigated promptly if the child complains of headache associated with fever and stiff neck, the worst headache of his/her life or a headache that goes on for more than a week. If a child is missing more than one day/month of school, has missed at least one week of school due to headache or the headache is interfering with the child's normal activities, the headache needs to be investigated and treated using a comprehensive approach which included identification of triggers, addressing lifestyle issues, management of stress as well as appropriate medication for the type of headache the child has.

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Are over the counter pain medicines safe to use for children's headaches? Giving OTC pain medicines for an occasional or episodic headache is a reasonable treatment. However, if a child is routinely taking pain medication for headaches more than 3 days/week, the child is at risk for rebound headaches. Rebound headaches are caused by overuse of analgesic (pain) medications. Although the medicine initially works to relieve the headache, recurrent use of the same medicine can actually perpetuate and intensify the headache.

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What else, besides medicine, can be done for severe headaches? Children with severe, often chronic headaches require a comprehensive approach by a coordinated team of qualified professionals. A headache management plan involves a headache diary, appropriate medication, lifestyle modification, diet and stress strategies. Children and their families need to be education about their headaches and given appropriate strategies to successfully manage their condition.

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