Neurology - Headaches Flashcards
What are the majority of headaches caused by in children?
Simple tension type that resolve with paracetamol and water
What are the different causes of headaches in children?
- Tension
- Migraines
- ENT infections
- Analgesic headaches
- Vision problems
- Raised ICP
- SOLs
- Meningitis
- Encephalitis
- CO poisoning
What is the typical presentation of a tension headache?
Pressure around head in a band-like pattern
Gradual
No visual changes
No pulsations
Symmetrical
How long does it take for tensions headaches to resolve in children?
30 minutes
What causes tension headaches in kids?
Stress, fear or discomfort
Skipping meals
Dehydration
Infection
How are tension headaches managed in kids?
Reassurance
Analgesia
Regular meals
Avoiding dehydration
Reduced stress
What are the different types of migraine?
Migraine without aura
Migraine with aura
Silent migraine (migraine with aura but no headache)
Hemiplegic migraine
Abdominal migraine
What are the symptoms of migraines?
Unilateral
Severe
Throbbing
Longer to resolve
What are migraines often associated with?
Visual aura
Photophobia and phobophobia
Nausea and vomiting
Abdominal pain
How are migraines managed in children?
Rest, fluids and low stimulus environment
Paracetamol
Ibuprofen
Sumatriptan
Antiemetics e.g. domperidone
What prophylactic can be used for migraines?
Propranolol (avoid in asthma)
Pizotifen (causes drowsiness)
Topiramate (HIGHLY TERATOGENIC)
How do abdominal migraines present?
- Central abdominal pain over 1 hour
- Nausea + vomiting
- Anorexia
- Headache
- Pallor
If a patient presents with possible migraines what should you ask?
Ask about recurrent central abdominal pain
In children with new headaches what should you check for?
Infection, can cause headaches
Typically resolves as infection does
Paracetamol + Ibuprofen can be used for symptomatic relief
What is sinusitis associated with?
Headache with inflammation in sinuses
- Ethmoidal
- Maxillary
- Frontal
- Sphenoidal
Causes facial pain behind eyes, nose and forehead
Tender over affected sinuses
