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By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Headaches are very frequent with children that go to school but rarely with children less than 5 years old. Tension headaches are the far most frequent form. The pains feel like a tight band around the head and the muscles in the neck are often sore. Children also have migraine. Most headaches are handled with common medication bought over the counter. You must contact the doctor immediately, if the child has trouble talking, becomes drowsy or has trouble controlling arms or legs while having a headache.

Every third child that goes to school complains about frequent repeated headaches, while headaches are rare with children less than 5 years old. The most common forms of headache are tension headaches and migraine. Especially tension headaches are common and we believe that about half of all school children have experienced tension headache. Migraine is more rare but before puberty around 10% have had one or several cases of migraine.

Tension headache feels like a tight band around the head. The pains vary from light to moderate. With most children, the tension headache lasts from 30 minutes to a few days. Tension headache is caused – as implied in the name – by tension in the musculature. Therefore, most children have sore muscles in the neck and shoulders. The muscles tense up when the child is stressed out by for example problems at school, anxiety or expectation of something new or exciting. Incorrect postures in school furniture or in front of a television/computer can also lead to tense muscles and thereby tension headache. Finally, grinding one’s teeth and poor eyesight are common causes of tension headaches.

Migraine is often positioned in the forehead or in one or both temples. The pain comes in attacks and is described as strong and throbbing or pounding. Movement worsens the pain and the child should therefore preferably lie perfectly still. Often the headache lasts for 1 to 6 hours but it can last up to 48 hours. Lack of appetite, nausea, vomiting and sensitivity to light and sound are common. Therefore, the child prefers to be in a room without light and noise. The children are often pale and quiet. An attack of migraine can be triggered by tension, problems, anxiety, hunger and lack of sleep. With a few children, migraine is triggered by certain foodstuffs – including frequent intake of sugar. Typically, siblings or parents have migraine too.

Tumours in the brain can cause headache but this is an especially rare cause of headache. If this is the case, often, the child will wake up with a strong headache, vomit violently and have trouble moving around normally.

A common cause of headache is infections that bring fever. Most infections (influenza, common cold, etc.) cause headache. You must pay special attention, if the child has a high fever, headache and is stiff in the neck at the same time – this can be sign of meningitis.

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Both tension headaches and migraine can be soothed with ordinary painkillers bought over the counter, for example paracetamol. Be aware that a daily use of painkilling medication can lead to headaches. If the child suffers from migraine and ordinary painkillers are not enough, the doctor can prescribe a special medication for treatment of migraine.

What can you do?

It is possible to prevent headaches. Make sure that the child has regular sleep, regular meals and do all-round exercise. Adjust the furniture the child uses not to cause tension in the musculature. If the child grinds its teeth, a dentist should examine the child’s bite. The child’s eyesight should be tested with an optician or an ophthalmologist.

Contact the doctor tomorrow

If the headache increases – either in frequency or pain. If the child suffers from migraine and ordinary painkilling medication is not enough.

Contact the doctor immediately

If the child has trouble talking, becomes drowsy or has trouble controlling arms or legs while having a headache. If the child has a headache, fever and is stiff in the neck.