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
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
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
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
5
Q
What Rx are there for a simple headache?
A
- Paracetamol (15mg/kg PO)
2. Ondansetron (4mg 15-30kg, 8mg >30kg) if active vomiting
6
Q
What Rx are there for a migraine in children?
A
> 12yo:
- Aspirin 1g PO
- Sumitriptan (nasal 10-20mg)
- Chlorpromazine (0.15ml/kg IV in 1Lsaline over 1hr, beware hypotension)
<12yo:
- Ibuprofen 10mg/kg PO
- Chlorpromazine (0.15ml/kg IV in 1Lsaline over 1hr, beware hypotension)