Headache And Lifestyle In Children: A Pediatrician’s Perspective

Headache And Lifestyle In Children: A Pediatrician’s Perspective
January 15, 2024 by admin

Children commonly complain of headaches. If you consult with the best pediatrician in Chromepet, he will confirm this observation. Headaches in children are not usually associated with any serious medical condition. However, it is important to subject them to a careful clinical assessment. This is because, at times, headaches may be an indication of certain conditions and, therefore, should not be ignored.

The type of headache that is common among children is acute symptomatic headaches. They are headaches that are often associated with urinary tract infections, viral fevers, malaria, typhoid, and various non-specific illnesses. Although acute symptomatic headaches related to conditions of the central nervous system such as meningitis, meningoencephalitis, and space-occupying lesions are less common in children, which needs to be ruled out. Primary headaches are another common but lesser-known type of headache in kids. They include migraine and tension headaches and, less commonly, cranial neuralgias.

A good strategy to follow when evaluating headaches in children is to keep a tab on history – their onset, duration, behaviour during each headache episode, and trigger and relieving factors. According to expert paediatricians, the examination of children with headaches should be focused on:

  • Identification of focal neurological deficits such as motor deficits and difficulty in coordination. A basic confrontation test should be done to rule out any major visual field defects.
  • Blood pressure measurement
  • Fundus examination by a paediatrician or ophthalmologist. However, it should be kept in mind that the presence of minor refractive errors does not cause headaches.

Neuroimaging is a radiological diagnostic test that is generally overused when investigating headaches in children. Clinical indications for neuroimaging are:

  • The presence of focal neurological defects on examination
  • The presence of papilloedema on fundus examination
  • Very young child (more than 3 years old)
  • Ventriculoperitoneal (VP) shunt
  • New onset headache (less than six months after onset) which relentlessly worsens
  • Very severe (thunderclap) headache

Headaches that have been present for more than six months are not likely to be associated with any significant neuroimaging findings. However, it is best to visit the best neurology hospital in Chennai for an evaluation.

Primary Headaches In Children:

In children, these types of headaches are common but are frequently overlooked.

Migraine Headache

Migraine is diagnosed by its episodic nature. Children often remain normal in between attacks. Migraine headache is characterized by at least two of the following features:

  • Photophobia or phonophobia – The headache worsens with exposure to lights or sound. Children would want to shut off the light and stay in silent surroundings during a migraine episode.
  • Nausea and/or vomiting during a few headache episodes
  • Pulsatile or hammering headache in the frontotemporal location
  • Family history of headaches
  • Avoiding daily activities such as playing, watching TV, etc.

A child experiencing four or more migraine episodes per month or frequent disruptions to the daily routine needs daily medication. Irrespective of the frequency of occurrence, acute pain medication may be necessary to relieve all migrainous headaches. Non-steroidal anti-inflammatory drugs (NSAIDs) may be effective if used at the onset of the headache. Certain specific drugs may be required in severe cases. In the longer term, it is important that parents have a clear understanding of migraine in order to inculcate lifestyle changes.

Tension Headache

Tension headaches are also episodic in nature but usually don’t have any specific characteristics. None of the characteristics of migraine may be present in tension headaches. The characteristics of a tension headache include:

  • Non-pulsatile
  • Generalized pain all over the head
  • Absence of photo or phonophobia
  • No nausea or vomiting.

In the case of children, it is important to take psychogenic factors into consideration irrespective of the type of headache they experience. However, children with tension headaches should be evaluated for psychogenic factors.

The lifestyle changes that enable overall wellbeing and help children lead a headache-free life are:

Sleep Hygiene:

It refers to cleaning out children’s sleep routines. As kids duplicate what parents do, it is important that the whole family follows a regular sleep routine, such as:

  • Following regular sleep rituals like changing into nightwear, brushing teeth, reading a story, etc.
  • Putting off all electronic gadgets at least an hour before going to bed
  • Having a specified sleep time or schedule (fixed sleep and wake-up time) even during weekends

Screen Time

Different types of electronic devices – televisions, mobiles, etc. – keep us awake for a long time. Even a few months old babies are being entertained using these devices. This is not good. Excessive use of these devices can harm young children in many ways. The parents can get their children off these devices only by taking them out to the park to play or involving them in activities of their interest. Limiting screen time to a maximum of one hour a day greatly reduces and even prevents headaches.

Fluid Intake

Sufficient fluid intake is essential for children living in warm and cold countries. Adequate intake of fluids improves overall health and reduces, or even prevents, headaches.


The regular physical activity enables children to improve their overall health and even prevent headaches. Children should be encouraged to participate in outdoor games on a daily basis. This helps them maintain a healthy body throughout their lifetime and build long-lasting relationships with their friends.

Sugam Hospital

Sugam is a leading multispecialty hospital in Chennai, and the neurology department has a team of experienced and expert neurologists and neurosurgeons. They are adept at providing treatment for all neurological problems, including headaches in children. The facilities offered by the hospital include modern operation theatres, well-equipped CCUs, rehabilitation support, and one of the top diagnostic labs in Chennai. The operation theatres are equipped with the Mayfield head stabilization system, Carl Zeiss magnification system, craniotome, a high-speed drill, and other state-of-the-art equipment for advanced medical care.