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Important facts about headaches in children

• 95% of them are not caused by a life-threatening medical condition.
• Tension headaches are most common, as they are with adults.
• Migraines are more common in children than in adults. If you have a family history of migraines, your child's headache is more likely to be a migraine.
• With proper multidisciplinary management, most headaches can be successfully prevented.

Headaches and school
Headaches during school can create difficult problems for students, parents and teachers. Concerns may include how to manage a severe headache at school, how to relate to peers, how to cope with homework when it hurts to read, and even whether to attend school or not. Fears of failure or falling behind can emerge when headaches become more frequent or severe, and parents may struggle with whether they should push their children or excuse them from activities.

Should children with severe headaches attend school?
It may seem cruel to force a child to study or attend school with a severe headache, but, if at all possible, it is better for a child with headache to stay in school and try to adhere to the normal routine of school life. Students who attend school despite the headache learn to conquer headache-related fears, overcome personal obstacles, maintain involvement with their peers, develop a positive attitude, and earn the respect of others and themselves. Those who avoid the normal routine due to pain can become increasingly isolated and depressed, and see themselves as failures.

How should parents react?
The normal parental instinct is to comfort a child in pain, but the more emotional distress a parent shows to a child in pain, the more upset the child becomes. This doesn’t mean that the pain must be ignored. Instead, parents should attempt to show compassion and understanding of the pain, but combine this with calm but firm expectations about schoolwork and attendance.

How to manage the headaches
It is essential that every child who suffers from headaches has a thorough medical and neurological examination, to exclude the possibility of a serious or life-threatening condition, especially in the presence of fever and neck pain, or if the pain is becoming progressively worse. Once serious conditions have been excluded, a multidisciplinary investigation into the cause of the headache is the route most likely to result in the effective prevention of further headaches in most children. - Dr Elliot Shevel, Director of the Headache Clinic.
 

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