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By: Dr. Jacques Doueck

Dr. Jacques Doueck interviews community healthcare professionals for state-of-the-art insight into how you can get healthy and stay healthy.

This month Dr. Jacques Doueck interviews
Dr. Henry Hasson, a child neurologist. The focus of their conversation is headaches in children – what causes them, how to treat them, and when to
be concerned.

How should a parent react when a child says, “I have a headache!” or “My head is hurting me?”

Headaches should be treated sooner rather than later. Talk to your child and see if there is something going on socially, or in school, that may be causing him to have a headache. Pressure from schoolwork, bullying, anxiety, or depression are common causes of headaches. Always have your child evaluated by a physician before making a determination.

Should parents consider certain foods to be a possible cause of headaches?

Yes. Some foods can trigger headaches. These include but are not limited to: snacks and soups that contain MSG, Chinese food, hot dogs (which contain nitrates) and foods with built-in caffeine. Skipping meals can also trigger headaches.

What are some of the
common headaches that
children experience?

Migraines and tension-type headaches are both very common. Although migraines are often genetic, they can also occur without a family history. Adult migraines and childhood migraines are somewhat different. Children may describe feeling dizzy and nauseous. They might also be bothered by loud noise and bright lights. For many of these children motion sickness on the school bus or certain smells can trigger headaches.

What is the relationship between sleep and headaches?

Poor sleep hygiene is a common cause of headaches. Having erratic sleep patterns or getting only a few hours of sleep per night can certainly trigger headaches.

What types of medications are used to treat headaches?

It is always best to avoid use of medication for headaches, and to prevent headaches by properly managing them instead.  When medication is needed, it should be used sparingly, as frequent use of pain killers can actually make headaches worse.  For tension-type headaches, medications like Tylenol and Advil (also known as Motrin) may be helpful. For migraines, triptans will help treat the ailment, rather than simply covering up the pain.  There are medications on the market to prevent headaches, but these should only be used when necessary.

What are some indicators that a headache is serious?

If a child wakes up with an early-morning headache, if the headache doesn’t get better when he lies down, or if the headache wakes the child up at night, there’s reason to be concerned that a more serious problem may be at work. A new type of headache,even if mild in nature, and certainly a very severe headache,may be cause for further evaluation. If needed, an evaluation with a neurologist may be helpful in more accurately diagnosing and treating the headaches. A simple neurological examination can often rule out more serious causes without the need for a CT scan or MRI. It is always important to have the guidance of a physician and a headache specialist, when determining the cause of headaches.

What are some of the common misconceptions that people have about the causes of headaches in children?

Headaches are often incorrectly attributed to sinus infections or poor vision.  Turning to antibiotics without a clear diagnosis of sinus infection can delay proper treatment and may even make things worse. Although evaluation with an ophthalmologist is a good idea, poor vision is rarely the cause of headaches.

Why is ADHD associated
with headaches?

Children with ADHD have a hard time concentrating and their minds get distracted easily. They may or may not be hyperactive, fidgety, impatient, impulsive, and disorganized. They sometimes have a difficult time sitting still in class or at dinner.  The stress caused by these factors can cause the child to have headaches.

Why is it important to have a child evaluated if you
suspect ADHD?

Sometimes a child that does not get evaluated by a specialist is suffering great frustration. We all like to avoid unnecessary medications, however sometimes the child suffers more by not being able to function in society in a healthy and productive way.