This week Bobbi Conner talks with Dr. Sara Ritchie about evaluating and treating headaches in children. Dr. Ritchie is an Associate professor of Pediatrics and a pediatrician at MUSC Children’s Health.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Headaches are very common in childhood, and most of the time children have headaches for the same reasons adults do. Doctor Sara Ritchie is here to talk about evaluating and treating headaches in kids. Doctor Ritchie is an Associate Professor of Pediatrics, and she's a pediatrician at MUSC Children's Health. Doctor Ritchie, what are some of the most common causes of headaches in kids?
Dr. Ritchie: When we think of headaches, we think of acute headaches and chronic headaches. So acute headaches, meaning fleeting, not recurring frequently, not chronic. Common causes of acute headache can be really any disruption in a routine or a status of health. So, for example, a viral illness, mild dehydration, mild head trauma all can cause acute headache. On the other hand, chronic headaches, so headaches that are occurring in more frequency, those might be related to migraines for example, actually a pretty common diagnosis in children or even something like poor vision. And that's causing a headache.
Conner: What's the best way to treat occasional headaches in children.
Dr. Ritchie: For occasional or acute headaches and especially school aged children, it's very fair to try your regular over-the-counter medications, so like Tylenol or Motrin. You also want to be really sure that the child is well hydrated. And, sometimes even just resting in a cool, dark room can do the trick without any of the other interventions.
Conner: When a child comes to you as a pediatrician complaining of chronic headaches, how do you get to the bottom of the cause of these headaches?
Dr. Ritchie: There's a lot of screening questions that go into evaluating chronic headache. We like to know about the duration and timing of the headache, the location of the headache in the head, the quality of the headache. For example. Is it stabbing? Is it throbbing? Is there anything else that comes with it symptom wise, like vomiting, vision changes? Are there specific triggers like stress or certain foods? Anything that you know makes it feel better? Anything that you know makes it feel worse. Is there any medication that has helped?
Conner: And then what can typically be done to help children who do have chronic headaches?
Dr. Ritchie: The first thing that we want to try and do is address any triggers that we've identified. So, for example, if we've realized that the sleep schedule is inadequate, we can try and help get that back on track. Oftentimes, I will say that imaging is not required to diagnose the type of headache that's going on. But sometimes we do use that if there's more serious reasons that we suspect. There are certain vitamins sometimes that we can use depending on what kind of headache we've found. So, for example B2 or riboflavin, magnesium supplements, those are super common vitamins that people might take to help prevent symptoms. And then sometimes we'll actually consult our pediatric neurologist if these initial steps that we've tried aren't helping.
Conner: What signs or symptoms might indicate a child has a headache that requires urgent medical attention?
Dr. Ritchie: We really worry about sudden, severe headache, especially a headache that comes with vision changes, sleepiness, confusion, projectile vomiting. We worry about headache with a stiff neck or neck pain, and especially in the setting with fever. We worry about daily headaches, worsening headaches, headaches that wake you up from sleep. All very important things that we evaluate because we don't want to miss signs of a very serious cause of headache.
Conner: Doctor Richie, thanks for this information about headaches and kids.
Dr. Ritchie: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
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