5 Signs Your Child Needs to see a Doctor for Chronic Headaches

Contributed by Chelsea Wicks, MD

As a parent, I understand how concerning headaches in your children can be. It sometimes can be very difficult to know when to worry. Here are a few guidelines I use when evaluating any child with a headache to determine if it is due to something concerning or something that needs to be worked through.

1. What time of day do the headaches typically occur?

For headaches that tend to occur in the late afternoon or evenings, I typically look for:

  • Possible vision problems causing all day eye strain.
  • Dehydration from not drinking enough water and eating too many salty snacks.
  • Possible allergies.
  • Low blood sugar from not eating enough.

If the child is waking up with headaches, especially in the middle of the night, this can be a red flag. One possible cause could be increased pressure in the head that rises while they are lying down.

2. Do they get relief from pain medication? 

If so, this is reassuring. Migraines can be relieved with pain medication if caught early enough, but they don’t always fully resolve if they have been going on for a while. Often the best treatment for migraines is sleep. In fact, often waking up headache free after having a bad headache can be a way to diagnose migraines. If your child does not get relief or sleep with pain meds, they may require further testing for persistent migraines or the possibility of increased pressure in the brain sometimes caused by a mass or other abnormality.

3. Are there any other neurologic symptoms?

With severe migraines, there can be some numbness and tingling involved in the face or upper extremities. However, with most children, numbness, tingling, weakness, change in speech or behavior is reason to be evaluated by a doctor right away to ensure there is not something more concerning causing these symptoms. Often X-rays and imaging can be warranted in this situation.

4. Are there triggers to the headaches? 

Migraines often have triggers such as something in the diet, allergy symptoms or hormonal changes such as adolescent girls starting their period. Identifying these triggers is important in being able to later prevent migraines from occurring.

5. Are there any other associated symptoms?

Vomiting with headaches is usually concerning. This again can be a sign of increased pressure in the brain. It can occur with intracranial masses, bleeding or other fluid up.  However, it can also occur with mild concussions or migraines.

Headaches with a fever could be due to the fever itself. If the fever is treated and the headache resolves, that is reassuring. However, if the headache continues it is worth getting your child evaluated.  It could be anything from a common viral infection to something as severe as meningitis if there is associated neck or back pain.

As you can see, there are a lot of factors to consider when if child had head aches., There is  reason enough to have the child evaluated to ensure there is not something that needs further treatment.

Remember not to jump to any conclusions and always have your child evaluated by their pediatrician. To find a doctor visit renown.org/findadoc.

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