Headache, which is defined as pain or discomfort referred to the head, is a very frequent reason for consultation in the pediatric age and a major health problem in childhood since it is among the most frequent causes of school absences. During the first 14 years of life, according to some studies,
Headache, which is defined as pain or discomfort referred to the head, is a very frequent reason for consultation in the pediatric age and a major health problem in childhood since it is among the most frequent causes of school absences. During the first 14 years of life, according to some studies, up to 96% of children have suffered an episode of headache.
Types of headaches in children
There are 2 large groups within headaches in children:
1. Primary headaches: On the one hand, the so-called primary headaches, among which are mainly migraine and tension-type headache.
2. Secondary headaches: are those that are attributed to another pathology. These last ones are much less frequent.
Focusing on the primary, which are common in children, we found some differences that define each one in terms of intensity, temporal pattern, accompanying symptoms, etc:
-Migrages: Broadly speaking, migraine is going to be a headache of moderate-severe intensity, often hemicranial and pulsatile, which interrupts the child's usual activity, usually accompanied by photophobia, sonophobia and vomiting and which can occur at any time of the day. In some cases, migraine is triggered by factors that patients clearly identify, such as the intake of foods such as chocolate or cheese or, in adolescent girls with menstruation (what is called catamenial migraine). It is very common that in the family of the child there are other members with this type of headache. Migraine has another peculiarity and is that sometimes it can be preceded by what is known as 'aura'. The aura consists of neurological symptoms (most often "flashing" visual symptoms) that appear before the onset of the headache and that disappear when the headache begins. Migraine is the most frequent cause of recurrent acute headache in childhood and adolescence. As of pubertal age, it occurs more frequently in girls (6%) than in boys (3.5%).
- Tension-type headache: Tension-type headache, on the other hand, is defined by recurrent episodes of headache, of variable duration, consistent in oppressive pain of mild or moderate intensity, of bilateral location and that is not worsened by routine physical activities . It is not accompanied by neurological focality or digestive symptoms (nausea, vomiting), and may present photophobia or phonophobia but not both.
The symptoms that we consider as alarm que and that make it necessary to rule out that it is a headache secondary to another pathology are intense and progressive headache accompanied by frequent vomiting in shotguns, behavior alterations or changes of character, weight loss, headache that wakes up at night, which increases with exercise, cough or postural changes, or persistent headache, which does not respond to the usual therapeutic measures. The diagnosis and treatment of headache in children
The diagnosis of migraine and tension-type headache is clinical, so that the clinical history reported by the patient and a normal neurological examination are sufficient to make the diagnosis without requiring imaging tests .
When a child has a tendency to present episodes of headache should seek to lead an orderly life, maintaining the schedules of sleep and order in the meals, since variations in these habits can trigger the headache. In the same way it is recommended to give analgesia at an early stage without waiting for the pain to be fully established since in that case it will be more difficult to disappear. Finally, if the headache is migrainous, it is convenient that the child
lie down in a calm and dark environment until the pain subsides .