When you hear the word headache, what image pops into your mind – a busy adult, hands on their forehead, head down, trying to regain concentration while paperwork seems to pile up around them? Or, do you imagine a six-year-old sitting away from her friends holding her head and crying? The most common response is – the adult. But, it turns out headaches are not at all uncommon among children and teens, and some of these headaches can be just as debilitating as those that plague grown-ups.
Just how common are headaches in children?
According to an article published by the American Headache Society, up to 82% of adolescents report having a headache by the age of 18. That statistic is astounding. A large U.S. study revealed that migraine affects 10% of school-aged children. That statistic peaks in adolescence with up to 23% of teenagers suffering from migraine. Pediatric and adolescent headache disorders are among the most undertreated, undiagnosed and disabling conditions of childhood.
Well-Being reached out to Christina Treppendahl, RN, MSN, FNP-BC, and her colleagues of The Headache Center in Ridgeland about the prevalence of pediatric headaches, and what parents should know if their child complains of frequent headaches.
“When children come to The Headache Center, they are typically experiencing chronic and/or debilitating headaches that are interfering with school, family and social activities,” notes Ms. Treppendahl. “You might be surprised how young some of our pediatric patients with headaches are. In fact, the youngest patient treated at The Headache Center is 2 years old.”
Kids and migraines
“Migraine is the most common neurologic disorder on the planet,” Treppendahl explains. “If a child is suffering from headaches, regardless the severity, duration, or frequency, they always should be evaluated by a medical professional. The initial evaluation of a patient with headaches is aimed at ruling out secondary causes (i.e., a mass lesion, CNS infection, metabolic disorders, hemorrhage, intracranial abnormalities). After a secondary head- ache disorder is ruled out, a primary headache disorder can be diagnosed by a specialist.”
According to Treppendahl, there are many childhood periodic syndromes that may be associated with migraine including: infant colic, benign paroxysmal torticollis, benign paroxysmal vertigo, cyclical vomiting syndrome, and abdominal migraine. Although they are benign and many are self-limiting, these can be very frightening for both the child and the parents. Some are very challenging to treat, causing a lot of disability.
Can a child be predisposed to having migraines if a parent has migraine headaches?
Migraine is a genetic neurological disorder. If one parent has migraine, the child has a 50% chance of acquiring migraine. If both parents have migraine, each child has a 70-90% chance of inheriting the condition.
“We encourage all people suffering from headache disorders to monitor their children for signs of developing headache disorders early in life,” notes Rebecca Adams, RN, MSN, FNP-C. “Recognizing and diagnosing headache disorders in the younger population as soon as possible can minimize disability and prevent the headaches from becoming a chronic condition associated with other comorbidities such as depression, obesity, and potential drug abuse.
Are there other common types of headaches besides migraine that affect kids?
There are many primary headache disorders but migraine is by far the most common. Others include, but are not limited to, cluster headache, hemicrania continua, and tension-type head- ache. All children with primary headache disorders should be managed by a headache specialist to receive appropriate education and receive FDA approved treatments specific to headache disorders to minimize disability as well as problems with school performance and attendance.
“It’s important to remember when treating children that they are not just ‘little’ adults. There are several medications and treatments available for the pediatric population that are specifically indicated for the treatment and prevention of migraine and other head- ache disorders,” says Treppendahl. “Recent studies have also shown the positive significance and impact that cognitive behavioral therapy plays in headache treatment of young children and adolescents.”
The Headache Center treats both adult and pediatric headache disorders. All of the headache specialists at The Headache Center attend several headache conferences each year to learn about the latest therapies and emerging treatments in both pediatric and adult headache disorders to stay on the cutting edge of headache medicine. The Headache Center also has a research department that enrolls qualifying subjects in multi-center clinical trials for medications and devices seeking FDA approval in both adults and adolescents.
Can the underlying causes of some headaches be serious?
According to Jenna Gaddy, RN, MSN, FNP-C, there are several causes of secondary headache disorder that can indeed be life threatening if not accurately diagnosed and treated in a timely manner. “When evaluating headache in children, there are several “red flags” to look for in the medical and headache history and the comprehensive neurologic exam that could indicate underlying organic pathology. The headache specialists at The Headache Center are trained to identify any abnormal variants and intervene accordingly and in a timely manner,” she concludes.
Christina Treppendahl, RN, MSM, FNP-BC, is founder and director of The Headache Center in Ridgeland. MS. Treppendahl is a Family Nurse Practitioner with a Master of Science degree in Neonatal Nursing from Vanderbilt University and a Post-Master’s degree in Family Nursing from MS University for Women. She is certified in headache medicine by the National Headache Foundation. She is the principal investigator in many clinical trials for headache treatment therapies seeking FDA approval, and she serves on advisory boards for many migraine and cluster headache pharmaceutical and device companies.