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Does your child constantly complain of headaches? If so, there may be more to the problem than you think. “Mummy, my head is hurting,” says your five-year-old, clutching his head between his hands. You know there’s something wrong; it’s the same routine replaying itself, day after day, week after week. And yet, you’re not sure how you can get help. Here’s what you need to know—if your child has epilepsy, headaches are likely to occur as a precursor to a seizure, or as an after-effect of a tonic-clonic seizure. Although rare, you might find that a headache is the only outwardly symptom of a seizure. Types of headaches Postictal headache As the most common epilepsy-associated headache, a postictal headache occurs after a seizure episode. Studies suggest that approximately 45% of epilepsy patients experience postictal headaches; while the majority manifest after tonic-clonic seizures, some can also occur after partial seizures. Postictal headaches induce widespread pain, which may be dull or chronic, persistent or intermittent. Such headaches can last anywhere between six and twenty-four hours, and can sometimes be debilitating enough to cut your child off from daily activity. Pre-ictal headache If your child experiences brief headaches that present dull, persistent or sharp pain, it may be a sign of an impending seizure. These headaches are known as pre-ictal headaches and occur before the onset of seizure activity. About 20% of seizure episodes are reported to be preceded by pre-ictal headaches, although the exact number is debatable as the seizure itself may cloud any memory of a headache. Migraine headache Kids as young as eighteen months can develop migraine headaches. Migraines cause throbbing pain on one or both sides of the head, and may also induce vomiting, nausea, or sound or light sensitivity. Additionally, your child may complain of blind spots, flashing or distorted visual images, or loss of sensation in the body. The frequency of such headaches differs widely from child to child; while some experience them in bouts for several weeks, others might have them as infrequently as once a year. Although the aura before a migraine shares a likeness to that of a seizure, there is still uncertainty about whether a migraine can also independently trigger a seizure. Ictal headache Ictal headaches are rare and vary in their symptoms. While some present a dull throbbing, others seem like a punctuating pain. Some start suddenly, while others build up. Among children with benign epilepsy of childhood with occipital paroxysms, up to 25% experience no other symptoms apart from headaches. The symptoms of migraine and epilepsy are so similar that an EEG is often the only way to differentiate the two. Treating headaches in kids It can be hard to watch your child in pain. The good news is, there are treatments available. For ictal headaches, your pediatrician might refer you to a pediatric neurosurgeon, who might, in turn, suggest seizure medication that can control brain waves. For other types of headaches, you might be advised an independent treatment plan for your child. Based on the severity and frequency of your child’s headaches, your pediatric neurosurgeon may recommend a curative approach (waiting until the onset of a headache in order to treat it) or a preventive approach (arresting its onset). If your child has a recurrence of seizures or headaches (these can be mutually exclusive), it’s important to get help. With proper testing and diagnosis, you can begin treatment, minimize symptoms, and keep pain from robbing their happy days. Does your child experience routine headaches? Medical testing and diagnosis can be your first step to giving your child a gateway to normalcy. Book an appointment with a pediatric neurologist in Chennai, Bangalore, Delhi, Hyderabad or Vijayawada today.
DCH, DNB (Pediatics)
Rainbow Children's Hospital, Banjara Hills, Hyderabad