child headache

21 February 2011

Now You Can Talk To Your Child About Chronic Illness…

… of course, you already could. But Gretchen Rautman’s new book, My Secret (illustrated by Kathleen Schmiedeskamp), is a great tool to help you.

I just finished reading My Secret, the story of a young girl with chronic headache. It’s not just about headache or migraine, it’s about chronic pain in general. It will encourage your child to talk about their pain, and to know they’re not alone.

The book also includes tips to help parents and others caring for children to know how to help.

I’m impressed with the book, so I want to get it out to those of you who have children with chronic pain, particularly migraine and headache. You can order the book on Amazon.

But even better — if you have a child with chronic pain, leave a comment below and write about your experiences. In one week from today I’ll choose 2 comments at random, and those two people will receive a free paperback copy of My Secret shipped to them directly.

More good news – all proceeds from the sale of this book go to the Migraine Research Foundation!

So get commenting, and be sure to tell your friends who have children with this challenge.

For more resources, start here: Children with Migraine, Children with Headache, Children with Cluster Headache

17 January 2011

Children’s Headaches – Should I Consider a Preventative Medication?

James Information, Medications 0

It’s a challenge to diagnose headache disorders, especially in younger children. But it’s becoming clear that it’s important, and more and more research is being done to help fight pediatric headaches.

Headaches are surprisingly common in children.

The catch is that sometimes even the children don’t really know how bad they are. The matter is further complicated when it comes to issues like migraine, where the symptoms can be so varied. Many people with migraine simply "don’t feel well", and have very little actual head pain. In children, abdominal migraine is common, where nausea may be the main symptom and the pain may be in the stomach.

It takes time to work with your doctor and child to uncover the symptoms and find a good treatment. But it’s important to do so. Catching headache disorders early can help avoid later complications. And children with frequent headaches can have extra trouble at school that can leave them farther behind than they need to be.

A preventative medication is something that your doctor may recommend if the headaches are frequent. The good news is, many medications have been found to really help children with migraine.

Some of the common medications that have helped children include:

Propranolol: A beta-blocker. Some brand names include Inderal, Avlocardyl, Inderalici, InnoPran XL, and Sumial
Flunarizine: A calcium-channel blocker. Brand names include Adalat, Cardizem, Isoptin, Nimotop, and Sibelium.
Topiramate: An anticonvulsant drug. Brand name Topamax.
Sodium valproate: An anticonvulsant. Brand names include Depakote, Epilim, Orlept, and Epival.
Amitriptyline: A tricyclic antidepressant. Brand names include Vanatrip, Elavil, and Endep.

Here are some things you and your doctor will want to consider when thinking about preventative medications:

How disabling are the symptoms? How often is the child having attacks? How is this impacting their daily life?
Are there other symptoms or co-existing disorders that could potentially be treated with the same medication? (For example, nausea, epilepsy, etc)
What are common risks and side effects associated with this medication? How will your doctor help you watch for these things over time?
Will a preventative medication help the child cut down on abortive medications? If you are giving your child "painkillers" more than twice a week, it’s very important you look for other options.
Is there a trial period? Is there a time when we could try taking the child off the preventative in the future?
What other treatments can be used alongside of (or instead of) the preventative medication? For example, changes in diet, biofeedback, an exercise program, CoQ10 etc.

In certain cases, preventative medications have helped children effectively fight headache and migraine symptoms. But do your homework, and remember that this is something you need to take one step at a time. Don’t expect an instant cure-all. But do expect to find a combination of treatments that works well.

22 November 2008

Caution: Giving Medications to Children

James Medications 1

Everyone should know that they need to be especially cautious when giving medication to children. But what special precautions should we take?

Caution when giving medication to children

I appreciated the reminders from ParentCenter last month entitled Seven medicines you shouldn’t give your child. There are some excellent reminders there.

Though the authors don’t give hard and fast rules (there are always exceptions), they advise against giving things like aspirin, over-the-counter cough and cold medicines (for children under 6), and anti-nausea medications.

The article also reminds us to check with a doctor before giving herbal remedies (some parents assume that these are safer than medications, which is not always the case).

There are a couple other common problems when it comes to headache and migraine in particular. First, giving too much acetaminophen/paracetamol is a common problem, because often times medications contain these ingredients and parent unknowingly give a double dose.

Second, giving "adult" medications. Some well-meaning parents see their children suffering something they’re well familiar with, and they’re tempted to try their meds for their kids. But many headache or migraine meds have not been properly tested for children, and can be dangerous. Some may be used for children at a different dose, but it’s important to do this under the care of a doctor.

There are more and more treatments specifically used for children with headache and/or migraine. For example, biofeedback and relaxation techniques have helped many children and teens. Some anti-nausea medication may be helpful, and even a preventative for migraine such as an anticonvulsant.

There are options out there – just remember to proceed with an extra measure of caution when trying to help a child.

22 August 2008

Have your child draw their headache (why and how)

James Discoveries & Stats, Tips 2

Diagnosing headache and migraine in children isn’t easy – especially in young children. And as many parents know from experience, it’s a challenge to even understand what’s happening in your own child. Should they go to the doctor? Are they just imitating someone else’s behaviour? Is this something new, or a headache they’ve had before?

There is increasing interest in using art to diagnose headache and migraine in children. So far, the results are encouraging.

A little background

Early last century, using drawings from children to diagnose mental illness began to become popular. Many of you are familiar with this approach (if only from the movies). There is some debate over how effective this type of diagnosis is, but the idea is spreading beyond just emotional and mental issues.

Having children "draw their headaches" is turning out to be surprisingly helpful. Investigations particularly in the 80s and recent years have confirmed this. Take for example the 2002 study The Usefulness of Children’s Drawings in the Diagnosis of Headache, which used the method with 226 children. The authors of the study found the method to be very accurate, and recommended it be used, though in conjunction with the normal medical histories and oral exams.

Earlier this year, a study of 48 children evaluated the use of art in the diagnosis of migraine (see Children and adolescent’s drawing for the diagnosis of migraine). Again, diagnosing with the drawings was found to be very accurate, meaning that artistic diagnosis used together with normal examinations could be very helpful.

Children tend to communicate many things better through drawing. They know something is happening to them, but don’t understand all the words we often use (like stabbing pain, nausea, throbbing).

Try it!

So my advice? Couldn’t hurt to try it. Try some of the methods used in these studies. In the 2002 study, this was the method (highlight mine):

At the beginning of the visit, before any history was obtained from the child or parent, each child was provided with a blank, unlined piece of white paper (8.5 x 11 inches) and a number 2 pencil with an eraser. The child was then asked to "Please draw a picture of yourself having a headache. Where is your pain? What does your pain feel like? Are there any other changes or symptoms that come before or during your headache that you can show me in a picture?" To minimize bias, no leading questions or additional instructions were given. Most children participated willingly; the remainder complied after a bit of encouragement. There were no refusals. Additional embellishment of the drawing (eg, words of explanation, labels) was neither encouraged nor prohibited, and many children added such explanatory notes to their picture.

Take the picture(s) to your doctor, as an extra tool for them to use. Children in these studies ranged from age 4 up to 19.

Additional thanks to Understanding Children’s Drawings by Cathy A. Malchiodi for some of this information. Read more about child migraine and child headache issues.

20 May 2008

Solve child’s sleep problems = solve migraine?

James Discoveries & Stats 0

No, it’s not that simple, but the connection needs to be investigated more. We know there is a strong connection between migraine and sleep problems in adults. Now we’re learning about the connection in children.

A recently published study involved 90 patients from age 5-19. 60 of the patients were diagnosed with migraine, the others had various types of headache. 56% of the migraine patients had sleep disordered breathing, as opposed to 30% of the other patients.

Dr Bradley V. Vaughn, a neurologist from the USA who was not involved in the study, made a good point: "Children with headache should be questioned about symptoms of sleep disorders because there’s a high incidence of them in this group"

Now, the incidence may not be so high in the general population. What I didn’t mention was that these were patients who already reported sleep problems and headache. The interesting point is that the percentage was so much higher in the migraineurs. Especially those with chronic or severe migraine simply didn’t sleep as well as the other groups.

True, patients with migraine are more likely to nap. Still, there is evidence that there is some underlying neurological problem that is triggering migraine and changing sleep patterns.

Other interesting things that were noticed: bruxism (clenching or grinding teeth) was present in 50% of children with tension type headache. Most of the children with sleep apnea were referred to an ear-nose-throat (ENT) specialist, and half of those children ended up with a tonsillectomy. Most (80%) of those children had significantly fewer and less severe migraine attacks. Interesting.

It’s not normal to do a polysomnography (a type of sleep test) for children with migraine. Maybe it should be added to the normal tests given. This link needs to be further investigated.

Read more on the study: AAN: Pediatric Headache Type Linked to Troubled Sleep, or read more about migraine in children.