Chronic Headaches in Children: Causes and Solutions

My child frequently experiences headaches?

I have a son who frequently experiences headaches, which are often accompanied by severe nausea, vomiting, and dizziness.
He reports that his headaches initially cause some blurriness in his vision, followed by numbness in his hands and then a tingling sensation in his tongue, along with slight swelling of his lips and weakness in his limbs, before the severe headache begins.
These symptoms have been present since he was in the third or fourth grade of elementary school, and he is now in the first year of middle school.
He often experiences these headaches at irregular intervals.
Sometimes he has headaches even when the weather is good, and other times they occur during significant weather changes.
When he was in elementary school, he stayed at Mackay Memorial Hospital in Hsinchu for eight days.
He has undergone various tests, including blood tests, MRI, and EEG, but no cause has been identified.
I wonder if the doctor could help.

Hui Ru, 30~39 year old female. Ask Date: 2020/11/21

Dr. Cai Zongzhang reply Neurology

Based on the symptom description, these symptoms are paroxysmal and not persistent, and the cause may not be identifiable upon examination.
It is recommended to seek immediate medical attention (neurology) during the onset of symptoms.

Reply Date: 2020/11/21

More Info

Chronic headaches in children can be a complex issue, often requiring a thorough investigation to identify the underlying causes. Based on the symptoms you've described, it seems your son is experiencing a range of distressing symptoms that include severe headaches accompanied by nausea, vomiting, dizziness, visual disturbances, and tingling sensations. These symptoms can significantly impact his quality of life and warrant careful consideration.

Potential Causes of Chronic Headaches in Children
1. Migraine: One of the most common causes of recurrent headaches in children is migraine. Migraines can present with a variety of symptoms, including visual disturbances (aura), nausea, and sensitivity to light and sound. The fact that your son experiences visual changes and nausea suggests that migraines could be a possibility.

2. Tension-Type Headaches: These are often related to stress, anxiety, or muscle tension. They typically present as a dull, aching sensation and can be accompanied by tightness in the neck and shoulders. However, the severity of your son's symptoms seems to suggest a more complex issue.

3. Secondary Headaches: These headaches are caused by underlying conditions such as infections (like meningitis), increased intracranial pressure, or even structural abnormalities in the brain. Given that your son has undergone extensive testing (blood tests, MRI, EEG) without any findings, this may be less likely, but it cannot be completely ruled out without further evaluation.

4. Psychological Factors: Stress, anxiety, and depression can manifest as physical symptoms, including headaches. If your son has experienced significant stressors, it may be worth exploring this aspect with a mental health professional.

5. Other Medical Conditions: Conditions such as sinusitis, allergies, or even gastrointestinal issues can lead to headaches. The fact that he experiences headaches with changes in weather could suggest a possible link to environmental factors or allergies.

Recommended Actions
1. Consult a Pediatric Neurologist: Since your son has already undergone various tests, it may be beneficial to consult a pediatric neurologist who specializes in childhood headaches. They can provide a more focused evaluation and may suggest additional tests or treatment options.

2. Keep a Headache Diary: Documenting the frequency, duration, intensity, and triggers of the headaches can provide valuable information for the healthcare provider. Note any associated symptoms, dietary habits, sleep patterns, and stress levels.

3. Consider Lifestyle Modifications: Encourage regular physical activity, a balanced diet, and adequate hydration. Establishing a consistent sleep routine can also help manage headaches.

4. Explore Treatment Options: Depending on the diagnosis, treatment may include medications for acute relief (such as NSAIDs) or preventive medications (such as beta-blockers or antidepressants) if migraines are diagnosed. Non-pharmacological approaches, such as cognitive-behavioral therapy, biofeedback, or relaxation techniques, may also be beneficial.

5. Monitor for Warning Signs: Be vigilant for any new or worsening symptoms, such as sudden onset of severe headaches, changes in vision, or neurological deficits. If these occur, seek immediate medical attention.

Conclusion
Chronic headaches in children can be challenging to diagnose and manage. Given the complexity of your son's symptoms and the impact they have on his daily life, it's essential to pursue further evaluation with a specialist. By working closely with healthcare providers and exploring various treatment options, you can help your son find relief and improve his overall well-being. Remember, you are not alone in this journey, and seeking support from medical professionals is a crucial step in addressing your son's health concerns.

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