The Pediatric and Adolescent Headache Program treats patients affected by both acute and chronic headaches, especially those with refractory headaches who have failed previous attempts at therapy.
For children whose headaches have resulted in excessive school absences and overuse of medication we offer a three-week inpatient rehabilitation program. An infusion suite is available on an urgent basis for those experiencing headache crises.
Overview
Headaches are very common in children and adolescents. In one study, 56 percent of boys and 74 percent of girls between the ages of 12 and 17 reported having had a headache within the past month. Many parents worry that their child's headache is the sign of a brain tumor or serious medical condition, but most headaches in children and adolescents are benign and are not the result of an underlying disease.
Causes
Many headaches in children and adolescents are the result of stress and muscle tension. Headaches are also common symptoms of sinus infections, colds, and the flu. The most common types of headaches in children and adolescents are muscle tension and migraine. By age 15, 7 to 10 percent of all children and adolescents have had migraines and 15 to 20 percent have had frequent non-progressive or tension headaches.
Tests and Diagnosis
The proper treatment will depend on several factors, including the type and frequency of the headache, its cause, and the age of the child. Treatment may include education, stress management, biofeedback, and medications.
Treatment and Drugs
Headache education
Education includes learning about your headache type and recording what triggers the headaches, such as lack of sleep, a poor diet, your environment, or stress. Your doctor will give you a Headache Diary to record the characteristics of your headaches and will recommend ways of managing the headache triggers. Bring this diary with you to all of your doctor appointments; this information will help your doctor correctly treat your headaches.
Relaxation techniques
Learning relaxation techniques can help modify the pain and/or frequency of the headaches. If you have a headache, you should:
- Lie down and relax
- Stretch and relax your muscles
- Apply a cold compress to your head
- Take a hot shower
- Take breaks from activities that trigger or provoke headaches, such as using the computer for long periods of time or exercising strenuously
Other ways to relax or reduce stress include:
- Deep breathing exercises
- Progressive muscle relaxation
- Mental imagery relaxation
- Relaxation to music
- Biofeedback
- Counseling (can help patients recognize and relieve stress)
Biofeedback
Biofeedback helps a person learn stress-reduction skills by providing information about muscle tension, heart rate, and other vital signs as a person attempts to relax. It is used to gain control over certain bodily functions that cause tension and physical pain.
Biofeedback can be used to help you learn how your body responds in stressful situations, and how to better cope. If a headache, such as a migraine, begins slowly, many people can use biofeedback to stop the attack before it becomes full blown.
Medications
Medications may be recommended to manage headache pain. Headache medications can be grouped into three different categories: symptomatic relief, abortive therapy, and preventive therapy. Each type of medication is most effective when used in combination with other recommendations, such as dietary and lifestyle changes, exercise, and relaxation therapy. In some patients, drugs from one or more of the three categories are used simultaneously.
Symptomatic relief – used to relieve symptoms associated with headaches, including the pain of a headache or the nausea and vomiting associated with migraine. These may include simple analgesics such as ibuprofen or acetaminophen, antiemetics (for nausea/vomiting) or sedatives (to help sleep; sleep relieves headaches). Some of these are available without a prescription (over-the-counter), while others require a prescription from your doctor.
Important: if symptomatic relief medications are used more than twice a week, see your doctor. Overuse of symptomatic medications can actually cause more frequent headaches or worsen headache symptoms. If this is the case, your doctor may want to prescribe preventive headache medications instead.
Abortive therapy – used at the first sign of a migraine to stop the process that causes the headache pain. By stopping the headache process, abortive medications help prevent the symptoms of migraines, including pain, nausea, light-sensitivity, etc. Abortive medications include: the triptans – sumatriptan (Imitrex), zolmitriptan (Zomig), naratriptan (Amerge), rizatriptan (Maxalt), almotriptan (Axert), frovatriptan (Frova), and eletriptan (Relpax); ergotamine tartrate and caffeine (Cafergot); dihydroergotamine mesylate (DHE-45, Migranal); and a combination medication (Midrin). These medications require a prescription.
Preventive therapy – used to treat very frequent tension headaches or migraines, or the combination of both types of headaches. Preventive therapy relies on taking a daily dose of a medication to reduce both the frequency and severity of the headache. Medications commonly prescribed as preventive therapy include: nonsteroidal anti-inflammatory (NSAID) drugs, antidepressants, antihistamines, beta blockers, calcium channel blockers, or anticonvulsants. Most of these medications require a prescription and take several weeks to work.
Specialty Care Providers Who Treat This Condition: