Headaches in Children

What are the signs and symptoms of headaches?

The signs and symptoms of headaches vary from child to child and can depend on the type of headache. The two most common types of childhood headaches are migraine and tension-type headaches.

Migraine headaches

Migraine headaches are recurrent headaches that occur at intervals of days, weeks or months. Migraines in children generally have some of the following symptoms and characteristics:

• Migraines last hours to days.
• Migraines are often in the frontal areas as well as the temples, and can be on one side of the head or both.
• Children complain of a throbbing, pounding or pulsating pain.
• Common symptoms associated with migraine headaches are nausea, vomiting, stomach pain, difficulties with bright lights or loud sounds, or sensitivity to smells.
• Warnings, called auras, may start before the migraine headache. These auras can include blurry vision, flashing lights, colored spots, strange taste or weird sensations. An aura usually occurs 5 to 60 minutes before the onset of the headache.

Tension-type headaches

Tension-type headaches are recurrent headaches that generally have some of the following symptoms and characteristics:

• They can last from minutes to several days.
• They feel like a band tightening around the head.
• Muscle tightness is noticed.
• Children may have sensitivity to bright light or loud sounds.

Chronic headaches

Headaches can become chronic when they occur more days of the month than not.

Chronic headaches can result from taking some types of medication—for example, acetaminophen (Tylenol), ibuprofen (Motrin), using caffeine or some prescription medications — more than 2 to 3 days per week. These are called medication overuse headaches.

What tests are used to diagnose headaches?

In general, headaches do not require any blood work or brain imaging. Depending on your child's headache symptoms, the following diagnostic tests may be requested by your primary care provider or neurologist at Children's Colorado:

• Brain MRI
• Lumbar puncture
• Electroencephalogram (EEG)
• Ophthalmology evaluation

How do doctors at Children's Colorado make a diagnosis?

The diagnosis of a headache is usually based on your child's medical history and a physical examination. Extra testing is rarely needed.

At Children's Colorado, headache diagnosis relies on using the International Classification of Headache Disorders criteria for headache types.

How are headaches treated?

Headaches are best treated with a combination of lifestyle and behavior modification. Your child's doctor at Children's Colorado may also suggest medication treatments to help your child's headaches

Why choose Children's Colorado for headaches and migraines?

Pediatric experts in our Headache Program collaborate with providers in multiple disciplines to offer comprehensive care for our patients with childhood and adolescent headaches. These disciplines include neurology, psychology, yoga therapy and nutrition. The Headache Clinic at Children's Colorado provides care of the highest quality to kids and adolescents with headaches. After your child is seen in one of our clinics, we'll work with your primary care physician to help manage your child’s headaches.

Our goals are to:

• Provide easy access to appointments and excellent care for children with headaches
• Provide care that is integrated with other subspecialties and supports children facing recurrent headaches
• Partner with your child's primary care physician to provide ongoing access to the tools and resources to evaluate and treat children with headaches
• Further research in the cause and treatment of headache disorders in children  

Types of clinics for headaches and migraines

We have several clinics to best fit your child's needs:

Preparing for your child's appointment

Referrals for appointment can be made either by physician referral or self-referral. Please contact your insurance provider to obtain prior authorization as needed.

We ask that you bring a copy of your child's pertinent medical records to the visit for us to review, unless they were obtained at Children's Colorado.

Pertinent medical records include:

• Notes from your child's primary care provider regarding the headaches
• Imaging studies (CT or MRI test results). If a CT or MRI was obtained, please bring a copy of the radiology report as well as a copy of the study on a CD
• Laboratory studies
• Electrocardiogram (EKG), echocardiogram or cardiology evaluation
• Sleep study results
• Optometry or ophthalmology evaluation 

If your child is experiencing headaches, your primary care provider is the best place to start. He or she can help guide you and make a referral to a specialist at Children's Colorado if needed.

Our work in headache and migraine research

Experts from the Headache Program at Children's Colorado are participating in several research studies for pediatric headache and migraine.

Please email us at headacheresearch@childrenscolorado.org or call 720-777-8588 if you are interested in participating or receiving information about our current headache studies.

Additional headache resources:

• American Headache Society
• National Headache Foundation