What to Do If Your Child Has Headaches

If your child complains of a headache but is otherwise well, you can use acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) to help relieve the pain. Also try dimming the lights and quieting the room. Turn off any music and put away loud toys. If the house is especially busy at the time, shut the door to the child’s room to keep the noise to a minimum.

Sleep is probably the best treatment for a benign headache. Although no parent can make a child sleep, encouraging rest and creating an environment conducive to sleep can help.

If your child has associated symptoms, address those as well. For fever, both acetaminophen and ibuprofen will help. A luke­warm bath can bring down the fever as well. For ear pain, drops of garlic-mullein oil (or even olive oil) dripped directly into the affected ear can temporarily relieve the pain.

When does my doctor need to be involved?

Call your doctor anytime your child has an incapacitating headache. When the headache is accompanied by persistent vomiting, visual symptoms, loss of balance, neck pain or stiffness, lethargy, or behavioral changes, let your doctor know right away. If your child has a fever with the headache and you don’t have an explanation for the fever (such as a cold), you should call your doctor.

If your child’s headache follows a head trauma, you should contact your doctor.

If your child has ear pain or sinus pressure in association with a headache, he should be checked by a physician.

What tests need to be done, and what do the results mean?

Most headaches do not require testing beyond a good physical exam. However, there are some scenarios in which tests will be recommended.

If your doctor suspects strep throat, a strep test will be done.

If there is concern that the headache is caused by a structural problem, imaging will be considered. MRI is the most sensitive form of brain imaging. However, it takes time (about an hour, if not more) to do an MRI, and most toddlers require sedation to cooperate. A CT scan can be done much more quickly — often without any sedation — but the imaging is not nearly as detailed. For certain problems, such as bleeding in the brain, a CT scan is as good as (if not better than) an MRI.

In rare cases, when meningitis or another serious illness is sus­pected, a spinal tap (also called a lumbar puncture) will be done. More often than not, a CT scan will be performed before the spinal tap. A spinal tap can demonstrate whether there is an infection, blood, or other unusual products in the fluid around the brain.

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