Disclosure :: this post is sponsored by Children’s Hospital.
A headache is one of the most common complaints encountered in medicine, as most everyone has experienced a headache at some point in their lives. Many people began experiencing headaches in their youth, making headache a common reason for visits to the pediatrician’s office. Studies around the world have estimated that between 37% – 51% of children will have experienced a headache in their elementary school years, and this estimate grows to 57% – 82% by the time children reach the age of 15 years. Most headaches are not severe and can easily be managed by one’s pediatrician, but occasionally children with headaches are referred to see specialists such as Child Neurologists for additional evaluation. With a headache being a very common reason for referral to our neurology clinic, in May of 2016, Children’s Hospital added a Pediatric Headache Clinic to their specialty clinic offerings to provide comprehensive care to those children being referred for evaluation of their headaches.
Headaches :: Types and Causes
Headaches are divided into two types :: primary headaches and secondary headaches. Secondary headaches are those caused by another medical problem which usually resolves with treatment of the initial problem. Common causes of secondary headaches are viral illness such as the common cold, allergy problems or sinus infections, and these are most often able to be treated by the child’s primary care provider. Primary headaches are those headache groups that are not due to another medical problem and are present due to simply having the headache condition itself, such as migraine or tension type headache. It is the primary headache disorders that may require the involvement of a specialist for your child’s care.
The Headache Clinic at Children’s Hospital
At the Headache Clinic at Children’s Hospital, our approach is to help define the type of headache syndrome for each patient and to help to establish a comprehensive care plan, or “Headache Plan,” tailored to each individual child. Once the headache type is defined, for children who are having rare or episodic headaches, our focus in to help families develop a plan of attack to effectively eliminate the individual headache episodes to minimize school absences, missed activities and recurrent trips to the doctor’s office or emergency room. For these patients, we will also attempt to help families to identify potential triggers or other factors contributing to the headache episodes.
Many patients, though, that are referred to our Headache Clinic are experiencing chronic headaches (greater than 15 days of a headache per month), which is where the comprehensive nature of our Headache Clinic can be most useful.
Conversion of primary headache disorder into chronic headaches are felt to be caused by several recognized factors:
- Overuse of medications for treatment of headache pain
- Unrecognized/untreated mental health conditions such as anxiety or depression or significant life stressors
- Inconsistent bedtime routines and sleep patterns
- Lack of healthy habits – nutritional patterns, hydration patterns and physical activity habits
- Caffeine intake
For children experiencing chronic headaches, we will spend time focusing on each of these factors in detail to develop a comprehensive plan of treatment that not only provides recommendations for medicinal treatment of the patient’s headaches, but also address all the factors felt to be contributing to the child’s headache to help to improve his or her overall wellness. We begin with a focus on counseling families on parameters to establish healthy habits for sleep routines, physical activity, meal habits, and hydration that are known to help decrease the number of headaches children are experiencing. For many neurologists, it is this focus on overall wellness that is felt to be the key to improving pediatric headache. In addition, from this clinic, we can help families establish counseling and mental health care if it is determined to be needed as part of the treatment plan, and we attempt to identify those children in whom a headache is a symptom of previously unrecognized anxiety or depression so that they can receive appropriate treatment. Finally, from a medication perspective, we provide treatment plans to help families reverse the effects of past overuse of headache medications and to help avoid patterns of overuse in the future.
With a headache being such a common complaint in pediatrics, we are delighted to now offer a specialty clinic at Children’s Hospital to address the needs of all children who are referred for evaluation of their headaches. From those children with rare headaches to those with frequent severe headaches, we can provide individualized and comprehensive care to help empower patients and their families to win the headache battle!
NOTE :: Patients are seen at the headache clinic twice per month at Children’s Hospital’s Metairie Center. Physician referral required.
About Jessica Gautreaux, MD
Dr. Gautreaux is an assistant professor of neurology at LSU Health New Orleans. Besides caring for children with a wide range of neurological disorders, she manages the Headache Clinic at Children’s Hospital. Dr. Gautreaux is board certified in psychiatry and neurology with special qualification in child neurology.