Treatment for headache in Ahmedabad
Headachein children
Headaches affect people of all ages – many adults remember having headaches as children.Headache in children can occur on its own (primary disorder) or as a result ofanother condition.
Primary headache disorders include migraine and tension type headache. The most common primary headache disorder is migraine without aura. The warning signs that sometimes come before the migraine, such as disturbed vision, strange taste or smells, orwobbliness, are referred to as an ‘aura’. Migraine without aura in children can be different to that in adults, in that they usually last for a shorter time and affect both sides of the head (bilateral).
Tension type headaches are the second most common primary headache disorder. These differfrom migraines in that they last longer and happen more frequently thanmigraines but are less severe although they are often also bilateral.
Although rare,headaches can sometimes be caused by other conditions. Before a primaryheadache is diagnosed, clinical assessments and tests can rule out or confirm asecondary cause.
1. How common isheadache in children and whom does it affect?
Up to 50 per cent ofchildren aged seven years and up to 80 per cent of 15 year olds haveexperienced at least one headache. Before puberty, headache affects girls andboys in equal numbers, but after puberty about three times as many girls getheadaches compared with boys.
2. What causes aheadache or migraine?
The tendency tosuffer from migraines is inherited. Someone else in a child’s family willsuffer from them too. There can also be triggers. Some migraine sufferers canidentify clear triggers. It is possible forthem to prevent attacks by avoidingthese, but it is rarely so straightforward.
Some peopleexperience dietary triggers where a migraine is initiated by eating aparticular food. Dietary triggers are uncommon except for caffeine and alcohol.Doctors know that migraines are not caused by eye problems, other medicalconditions, or having a particular type of personality.
It is much moreusual for migraines to be brought on by lifestyle triggers. These can includestress, fatigue, missed meals, sleeping in and/or any disruption to sleep, andalso spending too long on a computer. Unfortunately, these are all factors thatare impossible to avoid completely.
For some people, thetemperature of food (hot or cold) can trigger migraine.
3. How is headachediagnosed?
When a child withheadache is seen by a doctor, he or she will have a thorough examination to tryto work out what is causing it. The doctor will take a detailed medicalhistory, asking about when the headaches started and which part of the headthey affect. He or she will also ask about any other symptoms that occur at thesame time, such as feeling sick, avoidance of light or seizures. A child’s pastmedical history is also important to try to identify any previous illnesses orcurrent medical conditions that might trigger headache.
Other aspects of achild’s everyday life will be considered too, such as stress or problems atschool or home. This will help in identify the triggers for headaches. If otherpeople in the child’s family also have headaches or migraines this will also bediscussed as some types of migraine can be passed on from generation togeneration. The doctor will ask which headache treatments have been triedpreviously and to what degree they were helpful. The child’s physical conditionwill also be examined.
If a child’s medicalhistory and physical examination do not raise any concerns, it is unlikely thatfurther investigations will be needed.
4. What treatmentsare available?
Management ofheadache in children is multifaceted and involves a combination of approaches –making an accurate diagnosis, helping understand the condition, support at homeand school, psychological help, identifying and avoiding triggers andmedication.
Medication is of twotypes:
- Reliever – to use in the acute attack during or at the beginning of a headache.
- Preventive – taken every day to prevent them from occurring.
- Ibuprofen and paracetamol are both safe to use in children to treat headache, unless advised otherwise by your doctor or pharmacist. Both should be used according to the instructions on the bottle or packet.
- Triptans are an alternative to regular pain relief such as ibuprofen and paracetamol. There are different triptans which are available in various formats, such as tablets, melts, nasal spray and injection. Triptans can cause tingling sensations, warm flushes or tightness.
Preventativetreatment tends to be used if a child is getting regular and frequent migraineor headache which affects school attendance or daily life activities.
- Preventive medications fall broadly in to four major categories of medications – antihistamines, anticonvulsants, beta blockers
- Medication commonly used include cyproheptadine, propranalol, topiramate, amitriptyline and sodium valproate
- Flunarizine is believed to be an effective form of prevention for migraines.
Psychological waysof managing headaches can be very helpful. Sessions can either be on aone-to-one basis with a psychologist or in a group. The child might be asked tokeep a diary to identify any emerging patterns, which is the trigger forheadache or migraine. Learning ways of coping with headache pain can behelpful, such as relaxation, stress management and guided imagery.
8. What is theoutlook for children with headache?
More research isneeded to find out in more detail about the long term. In the majority,improvement or complete end to migraines by late teenage years is the norm.Finding a way of coping with headache can greatly improve quality of life.
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