Chronic Headaches in Teens: Symptoms and Seeking Help

Q: Chronic Headaches in Teens: Symptoms and Seeking Help

Hello： It seems to be a phenomenon of autonomic nervous system dysfunction, but first, check if thyroid function is normal. <br>Avoid stimulating foods, maintain a regular schedule, and increase daytime exercise for effective improvement.

Chronic headache

Hello, I am currently a senior in high school and have been troubled by long-term headaches.
I started experiencing headaches in the first year of middle school, which typically occur every afternoon.
Over time, especially after my third year of middle school, the pain began to occur earlier in the day, reaching around noon.
After entering high school, my physical condition has worsened.
I often wake up in the morning with gastrointestinal discomfort and feel dizzy.
Sometimes I experience chest tightness, palpitations, and tremors.
Recently, the timing of my headaches has become irregular, but I experience pain at least four to five days a week.
The pain starts mild and gradually intensifies, usually affecting the left side of my eye and extending to the top of my head.
During the worst episodes, it feels like two nails are being driven into the area above my left eye and the top of my head, resulting in explosive headaches.
At times, the pain radiates to the facial areas around my teeth, and occasionally I have headaches that extend to both temples.
The pain can occur from the afternoon into the evening or be triggered by loud noises.
My sleep quality is poor, with frequent dreams, a state of half-sleep, and disturbances often attributed to sleep paralysis.
Occasionally, I wake up choking on saliva or experience difficulty breathing.
I am prone to colds, and medications have little effect; taking them often leads to palpitations, weakness, and lack of energy.
For the past two months, I have been experiencing continuous palpitations and tremors, which have become more noticeable when I try to use chopsticks or write, and my balance is not very good.
My appetite during the day is extremely poor; I do not feel hungry if I don’t eat.
I have an appetite at night, but I can’t eat much.
I often experience nausea and vomiting.
I have lost five kilograms in weight over the past month and this continues (I weighed 41 kilograms three weeks ago).
I often find myself daydreaming, have poor memory, feel mentally foggy, frequently feel faint, and experience dizziness due to lack of sleep.
I also feel depressed and lack energy.
The headaches have become so severe that they make me cry and even contemplate self-harm.
In the second semester of my first year of high school, I underwent some tests.
I documented my symptoms for the doctor, who pointed out two symptoms I hadn’t noticed before: itchy skin (I forgot the other one), which I often experience.
At that time, I had a CT scan and electromyography at Dong Hospital, but the results showed no issues.
I would like to ask what might be wrong with my current physical condition and whether further examinations are necessary.
What could these symptoms indicate in terms of potential diseases or disorders?

Xiao Yun, 10~19 year old female. Ask Date: 2006/10/14

Dr. Ye Boshou reply Neurology

Hello: It seems to be a phenomenon of autonomic nervous system dysfunction, but first, check if thyroid function is normal.
Avoid stimulating foods, maintain a regular schedule, and increase daytime exercise for effective improvement.

Reply Date: 2006/10/14

More Info

Chronic headaches in teenagers can be a complex issue, often requiring a thorough understanding of the symptoms and a careful approach to diagnosis and treatment. Based on the symptoms you've described, it is crucial to consider several factors that could be contributing to your condition.

Firstly, the nature of your headaches is significant. You mentioned experiencing severe pain that feels like "two nails" being driven into your head, particularly around the left eye and extending to the top of your head. This description is characteristic of migraine headaches, which are common in adolescents and can be triggered by various factors, including stress, hormonal changes, and environmental stimuli. Migraines can also cause associated symptoms such as nausea, vomiting, and sensitivity to light and sound, which you seem to be experiencing.

Your reports of gastrointestinal discomfort, chest tightness, palpitations, and feelings of anxiety or depression are also noteworthy. These symptoms could indicate a possible connection between your headaches and anxiety or stress-related disorders. Adolescents often face significant academic and social pressures, which can manifest physically as tension headaches or migraines. The fact that you have difficulty with sleep, experience vivid dreams, and sometimes feel as though you are being "pressed down" during sleep (often referred to as sleep paralysis) may further suggest that your overall mental health could be impacting your physical health.

Additionally, the weight loss and poor appetite you mentioned are concerning. A sudden weight loss of five kilograms in a month, combined with a lack of interest in food during the day, could indicate an underlying issue that needs to be addressed. It is essential to ensure that you are receiving adequate nutrition, as poor dietary habits can exacerbate headaches and overall health.

Given that you have already undergone imaging studies (CT scan) and electromyography (EMG) with normal results, it may be beneficial to explore other avenues. A consultation with a neurologist specializing in headaches could provide further insights. They may recommend additional tests, such as an MRI, to rule out any structural issues that could be contributing to your symptoms. Furthermore, a comprehensive evaluation by a mental health professional could help address any anxiety or depressive symptoms that may be exacerbating your physical condition.

In terms of management, there are several strategies you can consider. Keeping a headache diary can help identify triggers and patterns, allowing for better management of your condition. Lifestyle modifications, such as maintaining a regular sleep schedule, practicing relaxation techniques (like mindfulness or yoga), and ensuring proper hydration and nutrition, can also be beneficial. Over-the-counter medications, such as acetaminophen or ibuprofen, may provide temporary relief, but it is essential to use them judiciously to avoid rebound headaches.

In conclusion, your symptoms warrant further investigation and a multidisciplinary approach to treatment. It is crucial to address both the physical and psychological aspects of your health to achieve a comprehensive understanding and effective management of your chronic headaches. Please consider seeking further medical advice and support to help you navigate this challenging situation. Your health and well-being are paramount, and there are resources available to assist you in finding relief and improving your quality of life.

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