Headaches in Children

What’s a headache?

A headache is pain in your child’s face or head. Headaches happen to 25% of younger children and 75% of adolescents. In fact, migraines are one of the top five most common diseases in children. Headaches are very common in both adults and children, and there are more than 150 types. Those types are typically divided into four categories:

Migraines

Migraines are episodic (occur a few times a month), severe headaches where your child experiences sensitivity to light and noise followed by nausea and vomiting. Migraines can be hereditary. About 60% of people who have migraines also have an immediate family member (mother, father, sister, and/or brother) who have them.

Tension headaches

There are four types of tension headaches:

• Episodic tension headache: A headache that lasts fewer than 15 days per month.
• Chronic tension headache: A headache that lasts longer than 15 days per month.
• Daily tension headache: Headaches that happen every day.
• Chronic non-progressive headache: Headaches that happen daily or a few times a month, but they don’t include the extra symptoms of a migraine.

Mixed headache syndrome/chronic migraine/transformed migraine

This type of headache is a combination of a migraine and chronic non-progressive tension headache. If your child has headaches more than 15 days a month with migraine symptoms, they might have this type of headache.

Traction and inflammatory headaches

These headaches may be due to an illness or brain disorder your child has. There could possibly be a brain tumor or bleeding in their brain.

How common are headaches in children?

Headaches are common in children. Among children between 5 and 17 years of age, 20% have reported getting headaches. The most common types of headaches in this age group are tension headaches (reported by 15%) and migraines (reported by 5%).

Many parents worry that their child’s headache is the sign of a brain tumor or serious medical condition. However, less than 3% of headaches are the result of these conditions. Many headaches in children are the result of stress and lifestyle issues.

Which children are more likely to get headaches?

If your child has an immediate family member who gets headaches, that puts them at a higher risk. Children with high-stress levels are also more likely.

How do headaches affect my child’s brain? Will they damage my child’s brain?

Headaches don’t cause brain damage. They don’t negatively affect your child’s brain.

How are headaches in children different from headaches in adults?

Children’s headaches differ from adults in the following ways:

• Children’s headaches often don’t last as long (between two hours and 72 hours).
• Children feel the pain all over their head, instead of just one side or section.
• Children have more stomach complaints, including abdominal pain, vomiting and nausea.

What are the symptoms of headaches in children?

Symptoms vary depending on the type of headache your child has:

Acute headaches

Acute headache symptoms happen suddenly and don’t last very long. Symptoms include:

• Sharp, throbbing pain.
• Pain in their head, neck or face.

Acute recurrent headaches or migraines

This type of headache lasts from one to two hours and usually happens two to four times a month.

• Pain that affects the front of their head, or both sides.
• Pale skin color (pallor).
• Upset stomach, nausea and vomiting.
• Irritability.
• Sensitivity to light, noise or smells.
• Dizziness.
• Fever.
• Blurred vision.
• Desire to sleep more than usual.

Chronic nonprogressive headaches or tension headaches

These are daily or frequent headaches or headaches that come and go over a prolonged period of time without causing neurological symptoms. If it occurs more than 15 days/month along with frequent school absences and medication overuse, see a headache specialist. Symptoms include:

• An ache or pressure in a “band” across their forehead.

Chronic progressive headaches

• Gradual increase in how often their headaches happen.
• Gradual increase in how severe their headaches are.

When chronic progressive headaches occur along with other neurological symptoms (for example, weakness, balance problems and visual disturbances), they can be the sign of such brain conditions as an abnormal build-up of fluid in their brain (hydrocephalus), inflammation of their brain, tumor or other conditions.

What causes headaches in children?

There are many possible causes for headaches in children. They include, but aren’t limited to:

• Simple illnesses like the flu, an infection or a fever.
• Sinus infection.
• Sore throat.
• Ear infections.
• Head trauma.
• Stress.
• Anxiety.
• Depression.
• Tension.
• Exercising too much (happens to athletes, for example).
• Meningitis (infection or inflammation of the membrane that covers their brain and spinal cord), which is rare.
• Encephalitis (inflammation of their brain), which is rare.
• Hemorrhage (bleeding in their brain), which is rare.
• Tumor (a mass of abnormal tissue), which is also rare.

Are headaches a sign that my child has juvenile diabetes?

While a headache isn’t a usual symptom of diabetes, it can indicate that your child’s blood sugar is low, which itself is a symptom of diabetes.

How are headaches in children diagnosed?

In order to evaluate and diagnose the headaches, your healthcare provider will need to perform a physical examination. They’ll check for things like:

• Fever.
• High blood pressure.
• Muscle weakness.
• Balance problems.
• Vision problems.

They’ll also interview you and your child. It’s helpful to keep a diary of your child’s experiences leading up to your appointment. This can help with the interview process. Your child’s healthcare provider may ask several questions, such as:

• When did the headaches start?
• How long have the headaches been happening?
• How often do they happen?
• What triggers the headaches? For example, do certain foods, situations, physical activity or medications cause a headache?
• Who else in the family has headaches?
• Are there any notable symptoms that happen between headaches? For example, does your child also experience weakness, changes in vision or loss of consciousness?
• Are the headaches keeping your child from attending school? Are they bothering your child during school?
• How are the headaches affecting your child’s quality of life? Do they spend a lot of time in bed? Do they miss out on playing with friends?
• Where is the pain located?
• What does the pain feel like?
• How long does the pain last?
• What makes the pain feel better?
• What time of day does your child get a headache?
• Do the headaches happen suddenly?
• Is there an aura before the headache? Do they experience changes in visions or blind spots? Do they see bright lights or experience numbness and tingling?
• What other symptoms happen at the same time as the headache? Examples include weakness, nausea, sensitivity to light or noise, decreased appetite and changes in attitude or behavior.
• What treatments have you tried at home? Medication? Ice packs? Turned the lights off in the house, etc.?
• Have you spoken to other healthcare providers about the headaches?
• Have you seen a headache specialist?

What tests can help diagnose headaches in children?

Your child’s healthcare provider may request imaging tests to figure out what’s causing the headaches. These tests may include:

• MRI (magnetic resonance imaging).
• MRA (magnetic resonance imaging of the arteries).
• CT scan (computed tomography).

How are headaches treated in children and adolescents?

When treating headaches in children, healthcare providers keep the following in mind:

• The age of your child.
• The type of headache.
• How often the headaches happen.
• The cause of your child’s headache.

There are four main treatments for your child’s headaches. Your healthcare provider may recommend one or more of the following:

1. Medications.
2. Headache education.
3. Lifestyle changes.
4. Stress management.

Medications

Depending on the suspected cause, your child might need medication to:

• Relieve symptoms (symptomatic relief). These medications relieve headache symptoms, including pain, nausea and vomiting. Examples include ibuprofen (Advil®, Motrin®), naproxen (Aleve®) and acetaminophen (Tylenol®).
• Stop a headache after it has started (abortive therapy). Your child should take these medications at the first sign of a migraine. By stopping the headache process, abortive medications help prevent the symptoms of migraines such as pain, nausea and light sensitivity. In addition to over-the-counter pain relievers, examples include short-acting triptans such as sumatriptan (Imitrex®) and long-acting triptans such as frovatriptan (Frova®).
• Keep the headache from ever starting (preventative therapy). These medications attempt to prevent very frequent tension headaches or migraines, or the combination of both types of headaches. It relies on taking a daily dose of a medication to reduce both the frequency and severity. The best medication depends on the root cause and other factors. Examples include antidepressants, antihistamines and beta-blockers.

Headache education

Your healthcare provider may teach your child about certain headache triggers. Common triggers include:

• Lack of sleep.
• Specific foods.
• Caffeinated drinks (tea, coffee, soda).
• Chocolate.
• Nitrates (lunch meats, ham, bacon, sausage, pepperoni, hot dogs).
• Aged cheeses (tyramine-containing foods, like pizza).
• MSG-containing foods.

Lifestyle changes

Poor lifestyle habits can cause headaches. To reduce the risk of headaches, make sure your child gets:

• Eight hours of sleep every night.
• Six eight-ounce glasses of water every day.
• Three healthy meals every day.
• Cardio exercise (45 minutes, three times a week).
• Relaxation.

Stress management

Learning relaxation techniques can help reduce the pain and/or frequency of your child’s headaches. Stress management techniques may include:

• Deep breathing exercises.
• Mindfulness or meditation.
• Mental imagery relaxation.
• Music therapy.
• Counseling.

Who will treat my child’s headache? Will they need to see a specialist?

Your child’s healthcare provider may refer them to the following specialists:

• Headache specialist.
• Ophthalmologist (vision issues).
• ENT (ear, nose and throat specialist for balance problems).
• Gastroenterologist (for stomach problems).
• Psychologist or psychiatrist (for stress and emotions).

How are headaches in children prevented?

Avoiding triggers and taking preventative medications can help reduce the risk of headaches. Ask your healthcare provider which medications are most effective for your child.

How can my child avoid triggering a headache?

Each child is unique, and so are their triggers. One goal is to identify what triggers cause the headaches, and then prevent the headache by avoiding them. Again, the most common triggers include:

• Lack of sleep.
• Specific foods.
• Caffeinated drinks (tea, coffee, soda).

What’s the outlook for children who experience headaches?

Headaches can affect your child in several ways. They can reduce their quality of life at school and home. But avoiding common triggers and finding appropriate treatment can significantly improve your child’s quality of life.

When can my child go back to school/daycare?

Discuss the severity and frequency of the headaches with your child’s healthcare provider. They may have recommendations regarding school/daycare. Also, inform your child’s teachers and caretakers about their situation.

Do children outgrow headaches?

As your child grows, headaches may disappear. But they may return later in life.

When should I take my child to see a healthcare provider?

• When your child has more than the occasional headache.
• When your child’s headaches are severe.
• When your child’s headaches happen suddenly.

When should I take my child to the emergency room?

Don’t hesitate to go to the emergency room if any of the following symptoms happen at the same time as a headache:

• Weakness.
• Diarrhea or vomiting that won’t stop.
• Vision loss.
• Confusion.
• Fever.
• Dizziness.
• Numbness.
• Shortness of breath.
• Stiff neck.
• Any changes to the ears, throat, eyes or nose.

What questions should I ask my kid’s healthcare provider about headaches?

• What type of headache does my child have?
• What’s the best treatment?
• What should I keep track of in a headache diary?
• What’s the best way to reduce my child’s stress?
• Are there home remedies I can try?
• What specialist should my child see?
• What medications are best?
• What should I tell my child’s teacher about their situation?
• How can I best help my child?

A note from Cleveland Clinic

Remember, it’s not uncommon for a child to have headaches. Although they may happen frequently, interfere with your child’s life and be very painful, headaches won’t cause permanent damage to their brain and it’s very unlikely there’s a brain tumor. If your child is struggling with headaches, schedule an appointment with your healthcare provider right away. And be sure to keep track of your child’s medications and lifestyle changes. They’ll need your help to get the best treatment.