Headache Flashcards

1
Q

Aetiology of headache in children - most common and NTBM

A

Most common:

- ENT involvement
- Migraines
- Tension headaches 

NTBM:

- Meningitis
- Raised ICP - space occupying lesions, SAH
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2
Q

What are some red flags for headaches in children?

A
  • Acute and severe
  • Progressive chronic headaches
  • Focal neurology
  • Age under 3yrs
  • Headache/vomiting on waking
  • Consistent location of recurrent headaches
  • Presence of VP shunt
  • Hypertension
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3
Q

When might you consider an MRI for headaches in children?

A
  • Abnormal neurology
  • Meningism (consider LP)
  • Marked changes in behaviour
  • Symptoms of raised intracranial pressure
  • Increasing frequency of undiagnosed headaches
  • Onset of severe headache
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4
Q

What environmental/general adjustments can you recommend for mx of a simple headache?

A
  • Limit treatment with medication to 3 times per week to prevent overuse/rebound headaches
  • Hydration
  • Avoid caffeine and alcohol
  • Don’t miss meals
  • Headache diary with GP F/U
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5
Q

What Rx are there for a simple headache?

A
  1. Paracetamol (15mg/kg PO)

2. Ondansetron (4mg 15-30kg, 8mg >30kg) if active vomiting

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6
Q

What Rx are there for a migraine in children?

A

> 12yo:

  1. Aspirin 1g PO
  2. Sumitriptan (nasal 10-20mg)
  3. Chlorpromazine (0.15ml/kg IV in 1Lsaline over 1hr, beware hypotension)

<12yo:

  1. Ibuprofen 10mg/kg PO
  2. Chlorpromazine (0.15ml/kg IV in 1Lsaline over 1hr, beware hypotension)
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