The child has a pain in the back of his head. Common causes of headaches in children, preventive measures. Main causes of headaches

Complaints of headaches are common in children and adolescents. These may be isolated cases or periodically recurring attacks, but in any case, a child’s headache (cephalgia) should not be ignored by parents and doctors, as it may be a sign of a serious illness.

The brain tissue itself does not have pain receptors; the nerve endings of the cervical spine and meninges, muscles of the face and neck, etc. are responsible for the occurrence of unpleasant sensations.

Headache - a symptom of many various pathologies and can appear at any age of the child. At the same time, in infants and children under 3-5 years of age, cephalalgia is often long time remains unrecognized, since young patients cannot formulate their complaints.

Possible causes of headaches in children:

migraine;
malignant and benign brain tumors;
inflammatory diseases of the central nervous system (CNS) – meningitis, encephalitis, arachnoiditis, etc.;
violation of the level of intracranial pressure (most often hydrocephalus);
epilepsy;
damage to the central nervous system due to exposure to toxic substances: drugs, alcohol, nicotine, chemicals active substances, organic poisons, carbon monoxide and many others. etc.);
traumatic brain injuries of varying severity;
ENT pathologies (sinusitis, frontal sinusitis, otitis media, etc.);
congenital malformations of brain structures;
tension headache;
acute viral and bacterial infections accompanied by hyperthermia and intoxication;
chronic diseases of other organs and systems of the child (kidneys, liver, of cardio-vascular system, hematopoietic organs, etc.);
incorrect spectacle correction of visual impairment;
acute caries and its complications (pulpitis, periodontitis, periostitis);
neurosis-like conditions;
pathologies of the cranial and facial nerves;
congenital and acquired deformities of the spine and bones of the brain and facial skull;

Cephalgia in young children

A peculiarity of the course of cephalgia in infants and children under 3-4 years of age is that often the child cannot express his complaints.

Most often the cause pain syndrome becomes hydrocephalus, intoxication, congenital pathologies of blood vessels and brain tissue and other diseases. An attack of pain may be accompanied by such phenomena as:

restlessness and irritability of the child;
refusal of food;
intense crying, intensifying with changes in the position of the body and head, noise and light stimulation;
spontaneous cries and shudders;
frequent regurgitation and vomiting;
bulging and pulsation of the fontanelle;
stiffness of the body and limbs;
head tilt, etc.

Such symptoms should not go unnoticed by parents and are a reason to immediately consult a doctor.

Headache in children 6-10 years old and adolescents

Cephalgia in children age category can be acute, paroxysmal or chronic in nature and is a sign of various diseases. Let's look at the most common causes of headaches.

Vascular cephalgia– is a symptom of diseases such as (vegetative-vascular dystonia), hypotension, hypertension, discirculatory encephalopathy, etc. Characteristic are pulsating, dull, aching, bursting headaches, most often localized in the occipital region. Cephalgia is accompanied by nausea, darkening of the eyes, dizziness, and pale skin.

Migraine. Age peaks of the disease occur at 6-7 and 12-14 years and correspond to the beginning of schooling and puberty in a child's life. The disease is characterized by attacks of acute throbbing headaches lasting up to 2-3 hours. Often the onset of an attack is heralded by the so-called aura: visual disturbances, lethargy and lack of appetite, tinnitus, dizziness, numbness of the face and fingertips, etc. The pain can be one-sided or two-sided, accompanied by vomiting, which brings relief.

Tension headache is the most common in school-age children and teenagers. Its occurrence is associated with psycho-emotional overstrain, incorrect position of the body and head when sitting at a desk, computer desk, excessive visual stress (a child spending a long time in front of the TV, monitor), incorrect spectacle correction of visual impairments, stress, and excessive physical exertion. The headache is of a compressive nature, has no clear localization, and may be accompanied by nausea and dizziness.

Cephalgia in inflammatory diseases of the central nervous system is severe and is accompanied by vomiting, convulsions, loss of consciousness, and various neurological disorders. The pain is highly intense and intensifies when the child’s body position changes or when exposed to light, tactile and noise stimuli. In severe cases of the disease, the child is in the “pointing dog position” - on his side, with his limbs bent towards the body and his head thrown back. These symptoms are a reason to immediately seek emergency care. medical care.

Cephalgia is often the only early sign brain tumors. Often such headaches appear in the morning, are persistent and are accompanied by repeated vomiting that does not bring relief.

Traumatic brain injuries and post-traumatic conditions often accompanied by headaches. Even in the absence of visible damage to the skull, the child complains of a localized or diffuse headache, accompanied by dizziness, nausea, vomiting, and visual disturbances. In severe cases, the attack may be accompanied by convulsions and loss of consciousness.

Psychogenic cephalgia may be paroxysmal (lasting up to 2 weeks) or permanent. Most often, children aged 8-13 years suffer from psychogenic cephalgia. The pain is moderate, dull, compressive, without clear localization. Various stressful and conflict situations provoke the onset of an attack.

First aid for headaches in children

First of all, it is necessary to find out the cause of the headache. If the disease that caused cephalgia is known (ARVI, otitis media, sinusitis, etc.), then correct treatment the main pathology will relieve the child from headaches. In addition, parents can take measures to alleviate an attack of cephalalgia:

provide the child with rest in a darkened room with access to fresh air;
exclude light and sound stimuli;
if the child is hungry, offer him some light food;
taking medications based on ibuprofen or paracetamol in a dosage appropriate to the child’s age.

If the above measures do not bring relief within the next few hours, you should seek medical help. Also a reason for immediate medical intervention are such features of a child’s headache as:

high pain intensity;
attacks of cephalalgia more than once a month;
night and morning pain;
accompanying symptoms: dizziness, nausea and vomiting, blurred vision, mental changes, disturbances of consciousness, coordination, sensitivity, etc.;
meningeal signs – hyperthermia, “pointing dog pose”, convulsions, loss of consciousness, neurological symptoms.

Diagnosis of the causes of headaches

In each case of paroxysmal or chronic cephalgia in children, it is necessary to find out its cause. Only a qualified healthcare professional can diagnose and prescribe treatment for headaches in children. At the initial appointment, the pediatrician performs a thorough examination of the child, collecting complaints, life history and illness.

In the future, consultations with other specialists (neurologist, psychiatrist, ophthalmologist, ENT doctor, dentist, oncologist, etc.) and examinations may be prescribed, including:

laboratory blood and urine tests;
X-ray examination - CT ( CT scan), contrast angiography, radiography;
MRI (magnetic nuclear tomography);
ultrasound diagnostics - ultrasound Doppler ultrasound (Doppler ultrasound), EchoEG (echoencephalography), duplex scanning, etc.;
radiological studies - SPECT (single photon emission computed tomography), PET (positron emission tomography), etc.

Parents of children complaining of headaches should not delay visiting their doctor. After all, early diagnosis and timely treatment are the main key to successful treatment of all diseases that cause cephalalgia in a child.

Any pain is dangerous for a child, but a special situation is the occurrence of pain, which can be a sign of problems with both the brain and many other systems and tissues. Particularly difficult is the problem with its recognition, especially in children early age who cannot describe their complaints in detail and accurately.

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It is important to understand that doctors always refer to headaches as danger signs, in healthy children such a symptom never develops.

The younger the child, the more serious usually are the reasons for the formation of headaches, especially those that arise against the background of complete health. They need to be identified and eliminated immediately.

Headache in a child: does it always indicate pathology?

For headaches with early childhood Many organic and functional causes have been identified, and such a complaint is one of the ten most common complaints among preschoolers and schoolchildren. Of course, headaches are also possible in young children, but they cannot accurately describe them, and sometimes doctors and parents have to recognize such symptoms on the basis of indirect signs.

If we talk about a child of preschool, and especially school age, then he can quite clearly and clearly describe his complaints regarding headaches. You can find out both the nature of the pain and the location and characteristics of the symptom. After a short questioning, you can find out in what situation and after what events the pain arose, and if it is repeated, what usually provokes it. You can also find out from children whether their pain is relieved or goes away completely.

Attention!A special situation is headaches in adolescents. They can arise due to temporary dissonance of growing and developing organism during puberty. But it is also important to take into account the fact that such pain may be an attempt at simulation because it is a subjective symptom that is extremely difficult for parents and doctors to assess.

For better understanding of all the processes that can occur in a child’s head, as well as to facilitate understanding of the causes of the development of pain and its origin, it is important to at least briefly examine certain anatomical and physiological foundations of the structure and functioning of the head. So, the brain itself does not have pain receptors, but there are a lot of them in all the formations surrounding it. All anatomical areas of the head have pain receptors that can form pathological impulses. The areas of the venous sinuses, cranial nerves and the area of the meninges are rich in pain receptors, in addition - large vessels of the head, periosteum or soft tissue in the skull area. In addition, all large vessels of the neck and facial tissues are equipped with pain receptors, which can also generate pain impulses with reflected signals.

The perception of pain is formed due to irritation of receptors with all kinds of chemical or physical impulses, excitation is formed and a flow of impulses is transmitted along sensory fibers to the pain centers of the brain.

If only certain areas or zones are excited, then the pain is felt as local, but if irritation is formed from large areas on the skull or internal structures surrounding the brain, a feeling of diffuse, general headache may occur.

Headache: definition of the concept

From a medical point of view, headache is one of the most extensive and extensive concepts. It is called the scientific term “cephalalgia,” but this definition can inherently include any unpleasant, subjectively uncomfortable sensation in the head area. Because of this, the concept of cephalgia includes both a feeling of heaviness and mild pain, as well as sharp, acute and painful pain.

Based on their localization, cephalgic pain is usually classified as sensations that occur over the entire area, starting from the brow ridges and to the border where the back of the head passes into the neck (the place where the skull is attached to the spine).

In children, headaches occur due to various reasons related to both the bone formations of the skull and its vessels or nerve endings and trunks, all the meninges, and its additional structures. Headaches may also develop due to various violations in the area of the cervical spine, as well as disturbances in the functioning of the shoulder girdle, pathology of internal organs, tissues or the whole body.

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It is important to emphasize that headaches are not diseases, they are just a symptom of pathologies and problems that have different causes and mechanisms of occurrence, but irritate receptors in the head area (often also the neck) and cause pain, interpreted as headaches.

Types of headaches in childhood

Not all headaches are the same in their origin and manifestations. Therefore, experts usually distinguish two groups of headaches:

If headaches are considered one of the leading symptoms in the clinical picture, or even the only complaints, and it is due to them that the child feels extremely unwell and has severe ailments, then we are talking about pain . This type of pain may be typical for various processes– microbial, viral infections. In addition, these types of pain are primary, typical for cluster or cluster pain, or tension headaches.
if headaches are one of many other extremely unpleasant symptoms, they are related to . Then these complaints are not considered leading in the clinic; they are regarded as a complex with all other manifestations, and they are typical for many pathological conditions and somatic diseases. Secondary headaches may be manifestations various types infections, febrile reactions, which will gradually disappear as the condition normalizes or the fever disappears.

If we talk specifically about secondary headaches, about two hundred reasons for their formation are known. There are much fewer primary pains, and they are usually stronger and more pronounced.

Causes of childhood cephalgia

Of course, list everything possible situations, in which headaches in children are possible, is almost unrealistic, since this manifestation can accompany almost any somatic and infectious diseases, and is also a manifestation of many traumatic, hypoxic and toxic processes. In addition, it is important to understand that several processes can provoke the development of pain, a combination negative factors and problems from the body, the impact of external and internal influences. But among the variety of processes leading to cephalalgia in childhood, we can identify the most frequently occurring and highly influential causes.

The most common and frequently recorded causes of pain in childhood are:

Consequences arising from bruises, falls or blows
Reactive reactions that occur in response to sudden changes external environmental factors - temperature fluctuations, precipitation or changes in geomagnetic conditions
Secondary pain of a reactive nature, formed as a result of changes in the body of children against the background of the development of allergies, prolonged sleep or constant lack of sleep, as a reaction to certain medical procedures
Reactions to infectious agents, taking certain medications or nutritional supplements, individual species products as a consequence of dehydration or a response to the problematic functioning of certain internal organs (kidneys, liver, heart).
Painful sensations that form inflammatory processes localized in the paranasal sinuses (ethmoiditis or pansinusitis)
Pain that occurs during an overdose, which was used without indications for it
Headaches associated with tension, if children are severe against the background of prolonged mental stress, prolonged sitting at the monitor
, which vary significantly in severity and duration, as well as the type of pain, or cluster headaches that rarely occur in adolescents, which have not yet been precisely clarified in origin.

The occurrence of any child’s complaints of headaches, even minimal and not acute, localized in the temples, frontal area or back of the head, should be a reason to consult a doctor, especially if there are no signs of colds or somatic infections, and headaches recur repeatedly.

Features of cephalgia depending on age

Headaches are possible at any time age group children, including newborns, but it is in the latter that it is most difficult to diagnose such symptoms. This is due to a complex of nonspecific behavioral reactions in response to pain impulses and the inability to verbally express one’s feelings. It is often very difficult for a doctor and parents to determine the exact location of pain and its strength. There are certain age-related features in the development of cephalgia, and the most associated with this typical reasons sensations:

In addition to age and the causes of the development of the pathology, it is also necessary to take into account the localization of painful sensations - frontal region, temporal or occipital, as well as the time of occurrence, duration of sensations and accompanying manifestations.

A variety of factors may play a role in the development of headaches in childhood, which include, in addition to all those listed earlier:

Various forms of headaches have their own specific clinical picture and accompanying manifestations, as well as features of the course depending on age limits, which is why it is worth examining the most common types in more detail.

Tension headaches: why they are special in children

This type of headache is functional and one of the most common in childhood. This type of pain and discomfort arises as a result of the negative effects on children of both acute stress factors and chronic ones, constantly affecting them day after day. Depending on age, stress factors can include various influences - too much physical activity, disproportionate to age, overwork from noisy games and an abundance of guests, if this is a young child, violent emotions and experiences (both negative and positive).

Mechanism similar pains, especially those related to stress, is relatively simple. A process of active and pronounced contraction of muscle elements in the head area is formed. This is especially reflected in the vessels, which also contract. The vessels located in the head and neck area, which, due to muscle contraction, come into a state of spasm, form irritation of pain receptors, resulting in a feeling of headache.

On average, the duration of such pain can range from a couple of hours to several days and even a week, it all depends on which factors affect the receptors. These pains are described as a sensation of squeezing or pulling the head with a hoop, a feeling sudden pressure in the area of the neck, temples or back of the head. In this case, sensations can be formed inside the head that are similar to the state of “wearing a helmet or hard hat.” The intensity of the pain is not very high, due to which the child remains functional and can perform everyday activities, performance and psyche do not suffer, but the learning process, concentration and behavior may suffer.

What makes these headaches special?

With them, painful sensations can intensify with physical activity or emotional experiences, and at the peak of the attack, nausea occurs with refusal to eat, intolerance to light and sounds, and increased pain from strong irritants of the sensory organs.

In some cases, such a headache can be triggered by the child being in a static position for a long time, especially during school hours. This may be due to the wrong selection of furniture for school and homework. The same kind of pain can occur with vision problems, due to tension in the visual analyzer.

Vascular pain: features in children

In order for the child’s brain, which consumes the largest amount of oxygen from all tissues of the body, to work actively and fully, it needs an uninterrupted supply of oxygen and nutritional components throughout the body. cerebral vessels. Due to various pathologies, dysregulation of vascular tone, prolonged stress or other factors, brain vessels spasm or become overstretched. As a result, blood either flows poorly to the brain or has difficulty flowing from it, which leads to a disruption in the supply of oxygen. The brain reacts quite acutely and sharply to such changes, which causes headaches. Such problems are typical for schoolchildren and adolescents, which in the future can result in manifestations of (VSD).

Changes in intracranial pressure: characteristics of children

Changes in cerebrospinal fluid pressure (this is cerebrospinal fluid, circulating around the brain) is possible in normal conditions against the background of physical activity and stress, with severe coughing and straining, when lifting heavy objects. Such temporary episodes do not manifest themselves in any way, and the pressure quickly comes to normal values. But when exceeding certain physiological values If symptoms of illness occur, you should consult a doctor in order to rule out serious pathologies and health problems.

The main symptoms include severe headaches in the morning with the formation of nausea and vomiting; these are the leading complaints of children. The background condition is always bad, but deterioration occurs in the late afternoon or at night. Typical for intracranial hypertension are nausea, leading to, which does not alleviate the condition or reduce pain.

Headaches with ICP are localized in the back of the head and form discomfort in the area of the orbits, which is formed due to excess pressure on the orbital area. Against the background of such pain, anxiety and constant crying, as well as sleep and appetite disorders, will also be typical.

There may be headaches due to low intracranial pressure - this is formed due to intestinal infections or injuries, but before the age of five, such symptoms of headaches are difficult to determine; children cannot accurately describe their sensations. You can indirectly guess about such a symptom by the presence of apathy and drowsiness, lethargy and weakness, as well as attacks of dizziness or even loss of consciousness. The nature of the headaches is dull and pressing, usually localized in the back of the head.

Headache due to infectious pathologies

One of the typical manifestations of many infections is headache and malaise, which occur against the background of viral, microbial or other types of infections. Often these symptoms are formed in combination with other manifestations of disease - fever of varying severity, pain in the throat, or chills, attacks of nausea or vomiting. Based on all these symptoms, in combination with an indication of contact with people with colds, it is easier to diagnose children, as well as identify the cause of pain in the head.

A special option is headache due to meningococcal lesions with suspicion of. It is typical for children at an early age, in the first year of life, as well as for preschoolers and schoolchildren. Fever and the formation of a severe headache are typical, which is then gradually joined by vomiting, which has nothing to do with nutrition and will not bring relief to children. General state children is quickly and progressively impaired; due to changes in intracranial pressure and tissue inflammation, children take forced positions with their legs brought to their chest and their heads thrown back. This condition is especially dangerous if dots appear on the skin of the body, similar to needle pricks or bruises, or stars.

Pathologies of the nervous system in childhood

Frequent sharp and acute headaches that have no other manifestations, are poorly relieved by analgesics and their symptoms are not typical for other problems may be a sign volumetric formations in the cranial cavity or certain health disorders. To exclude such processes, it is necessary to conduct a computer scan or to visually evaluate the anatomical formations in the brain area. Hemorrhages with the formation of hematomas, cystic cavities, can cause severe and painful headaches. They form a change in the anatomy inside the skull, which threatens a change in intracranial pressure. Typical manifestations of such problems are severe and painful headaches with nausea and vomiting, as well as problems with the sensitivity of certain parts of the body, visual disturbances and epileptic seizures.

Pain in young children

It is impossible to accurately determine whether a toddler has headaches; this is due to the fact that the child cannot speak or write down his complaints in detail. Symptoms such as restlessness and crying, sleep disturbances, provided that the child has been fed, is dry and not may indirectly indicate health problems and headaches. visible reasons for irritation. If all the reasons for the child’s discomfort have been eliminated, but he constantly cries and screams, a consultation with a neurologist is necessary. There are certain indirect signs, which may indicate infant headaches:

Screams and anxiety, prolonged crying intensify in the evening, intensification of screams when the body changes position, the baby moves from a vertical to a horizontal position and vice versa.
The veins on the head swell strongly, protrude and are very tense
The sleep process suffers, the child falls asleep screaming or sleeps very poorly both during the day and at night.
There may be sharp screams, shudders, and groaning.
He can pull his hands to the head, pull his hair
There may be frequent regurgitation of large volumes of food, vomiting
Loss of appetite up to complete refusal to eat
Often there is fever, sweating
The child is pale, drowsy, apathetic.
There may be disturbances in muscle tone, stiffness in movements of the limbs and body with tilting of the head

The causes of headaches at this age can be the development of hydrocephalus, congenital defects of the brain and its vessels, liquor spaces, intoxication syndrome and infection.

Headaches in children from 2-3 to 5-6 years old

Children at this age can also suffer from headaches, but often they can already partially explain themselves and show where it hurts. But at the same time, all the symptoms will be general and relatively blurred, especially in the younger age group. Typical ones would be:

Irritability and whims of the child, constant crying for any reason
Attempts to place the head on the hands or knees of adults, rubbing the head, pulling hair
Pallor and lethargy of the baby, refusal of noisy games and favorite activities, desire to lie down
Sleep and appetite disorders
Attacks of nausea with vomiting, sweating and dizziness
The child points to the head and complains of pain, but cannot accurately indicate the location or nature.

The causes of pain at this age are usually infections, somatic pathologies, toxicosis, consequences of head injuries and falls, tension pain associated with excessive emotional or physical stress, as well as pathologies of the nervous system.

Headaches in children over 6 years of age

In children over 6 years of age, headaches in their characteristics are approximately comparable to those of adults; the child can already accurately and adequately assess the location, strength and nature of the pain. At this age, headaches can be acute or chronic, attacking or constant. It can be a sign of various kinds of pathologies. Most often, these can be infections and somatic pathologies, vascular pain as a manifestation of vegetative-vascular dystonia (VSD), as well as migraines or pain as a result of tension.

Less commonly, pain occurs as a result of inflammatory, tumor or traumatic injuries the nervous system itself, which requires urgent consultation from a neurologist. There may be variants of psychogenic headaches in adolescence, which can be long-lasting and persistent. They are provoked by problems in the family, stress, and conflicts with peers.

What to do if a child has a headache?

Naturally, eliminating the cause of pain and treating the underlying disease in most cases leads to the elimination of the unpleasant symptom. But while the reasons are being clarified, or if there are extremely unpleasant symptoms of pain, we can help alleviate the baby’s condition. To reduce the intensity or completely eliminate an attack, the following are applicable:

Usually, these methods are quite enough to eliminate headaches; they go away within a couple of hours. If the pain does not subside, but only intensifies, you should consult a doctor or call an ambulance. The reason for going to the emergency room will be severe excruciating and unbearable pain, vomiting and dizziness, and inappropriate behavior of the child.

It is important to have a mandatory examination of the baby at any age if:

Constant and severe pain, the intensity of which is high and does not decrease when taking usual painkillers.
episodes of pain occur more than once a month.
There are symptoms such as nausea or vomiting, mental problems, visual disturbances, problems with coordination or sensitivity.
a skin rash, high fever, convulsions, various neurological symptoms and tilting of the head, convulsions appeared. You need to call an ambulance immediately.

Diagnosis and treatment of cephalgia in children

In each specific case, diagnostic tactics and treatment measures will depend on the causes that provoke the pain. To do this, you need to contact a pediatrician or neurologist, who will examine the baby, study all the complaints of him and his parents, as well as data from his life and medical history, which can help in recognizing the causes of the pathology.

A whole bunch of people can be appointed to find out the true reasons. laboratory tests, as well as radiography and contrast studies of blood vessels, CT or MRI of the head and neck. Vessels or ultrasound of the brain (if these are young children), as well as all sorts of additional studies that will be necessary for the doctor to establish an accurate diagnosis, can also be used.

Treatment is prescribed based on the cause that caused the attacks of cephalalgia. If these are episodic pains of tension, or attacks caused by overloads, certain influences, you can do without medications - you need to change your daily routine, reduce stress and good rest, the child's sleep, his prolonged stay on fresh air. Sedative and soothing teas and decoctions, infusions, rationalization of work and rest schedules, and avoidance of prolonged static exercise, television, and computers can help.

Alena Paretskaya, pediatrician, medical columnist

In children, headaches occur due to various reasons. In children under 2 years of age, malaise is most often accompanied by fever, which indicates an infectious disease. In schoolchildren, severe pain in the area of the back of the head and the crown of the head appears due to serious mental and physical stress, improper diet planning, and disruption of the daily routine. The pain can also be localized in the frontal region or in the temple area. If the temperature rises, you need to call a doctor at home and also visit a neurologist.

A headache in a child may be a sign of a serious illness.

Main causes of headaches in children

When a baby complains of a headache, it is necessary to find out the reason for the phenomenon. The cause of pain is initially determined by location, but the same location of pain indicates different diseases. Only a specialist can make a diagnosis and prescribe treatment.

Migraine

A 7-9 year old child often has migraines. Signs of this type of pathology are:

pain in the forehead and temple area on one side;
soreness of the eyeballs;
nausea turning into vomiting;
increased discomfort in bright light, noise in the apartment and strong odor.

Migraines often cause headaches in children hereditary disease. The pain comes in attacks. The temples hurt from several minutes to several hours. After vomiting, the child feels significantly better. Painkillers don't help. Appears before an attack general weakness and severe thirst, loss of appetite. Sometimes the patient feels dizzy and even loses consciousness.

Vegetative-vascular dystonia

A common cause of headaches in schoolchildren over 7 years old is problems with blood vessels. With stress and excessive load, vegetative-vascular dystonia (VSD) may appear. In addition, as a schoolchild grows up, he vascular tone is changing. The body does not have time to rebuild and experiences discomfort. VSD syndrome is the loss of the ability of brain vessels to respond correctly to stimuli. The vessels narrow and expand insufficiently or at the wrong time when it is needed.

VSD is a common occurrence in children with an increased level of mental activity - choleric people. Sometimes the syndrome occurs when the weather changes and in the morning after waking up. This is due to a violation of the venous outflow of blood from the brain. The autonomic nervous system is sensitive to rest and sleep patterns, poor nutrition, quarrels and troubles in the family and school. To reduce the risk of VSD, preventive measures should be taken.

Overvoltage

The most common cause of the described ailment in a child is physical or mental stress:

student overexertion during exams or before tests, test classes;
disruption of the daily routine with a decrease in night sleep time;
stressful situations at home or at school;
incorrect body position during sleep;
staying in a stuffy room;
spending long periods of time at the computer or watching TV;
starvation;
change of weather.

The mechanism of pain for these reasons varies. The first is muscle tension, leading to a certain inflammatory reaction. In this case, the vessels dilate and release a substance into the blood that irritates the pain centers. The second mechanism is a disruption in the ability of brain structures to respond correctly to changing conditions. At the same time, the emotional state of the patient changes, the balance in the production of hormones is disrupted.

Often the causes of headaches in children are classes, especially tests, during which most schoolchildren are nervous and worried

The pain is localized in the temples and frontal region, sometimes in the crown area. It is compressive in nature. The syndrome lasts for several hours. During this period, it may be painful for the baby to put on a hat, he even refuses to comb his hair. It happens that at the same time the muscles ache in the head, pain is felt in the stomach or heart area. The child complains of weakness, loss of appetite, and disturbed sleep.

Diseases of the ENT organs and eyes

Often the cause of headaches is diseases of the ENT organs or ophthalmological diseases. The essence of the phenomenon is that with inflammation of the throat or sinuses, as well as with pathology of the eyeball, pain receptors are influenced by irritating and toxic factors. If the eye is inflamed, then in addition to a painful sensation in the head, pain in the eye sockets and tearing appear. When the sinuses become inflamed, an unhealthy blush appears on the cheeks.

A pain reliever for inflammatory diseases nose, throat, ear and eye treatment is the treatment of the underlying disease. With such pathologies, the baby may develop a fever. You need to call a doctor at home or go to the pediatrician yourself with your child.

A child may have a headache during a cold.

Unstable intracranial pressure

Intracranial pressure in a healthy child increases due to heavy physical activity, coughing, and lifting heavy objects. After eliminating the cause, the pressure returns to normal and does not require treatment. Headaches in the back of the head when elevated indicate pathology. The main symptoms are:

nausea and vomiting, headache;
worsening of the condition in the evening and at night;
localization of pain in the back of the head and in the eye area;
unstable mental state – tearfulness, causeless anxiety;
disturbance of night sleep.

Intracranial pressure decreases due to head trauma, poisoning, and dehydration. If the child is small, it is difficult to understand where the pain is concentrated. You should pay attention to associated symptoms– lethargy, apathy, loss of appetite, drowsiness, dizziness. Older children identify the dull and pressing nature of the sensations. The pain is localized in the back of the head.

Viral and infectious diseases

If your forehead hurts, this is one of the symptoms viral disease. ARVI can be easily identified by additional signs - fever, cough, runny nose, sore throat.

Rhinovirus infection is accompanied by clear nasal discharge. The flu begins with a temperature rise to 40 degrees. In this case, the patient feels aching joints and sore skin. Adenoviral infection leads to damage to the eyes or intestines (we recommend reading:).

A pediatrician or infectious disease specialist treats viral infections. Head pain goes away when the disease subsides. A visit to the doctor is necessary because he knows what type of virus is common this year and what drugs block it.

Meningitis

Meningitis is an infectious inflammation of the lining of the brain. The headache is accompanied by vomiting and skin soreness. The sensations are aggravated by bright light, noise and sudden movements. The headache is localized in the forehead. Sometimes it affects the temples or is encircling in nature.

The typical posture for the patient is lying on his side with his knees tucked under his stomach, his head thrown back. You should not forcefully turn the child into a different position. Convulsions are possible.

Meningitis is treated in hospital. If the temperature rises and the above symptoms are present, you should call an ambulance. This is a dangerous disease - the patient must be under constant medical supervision. Treatment includes taking analgesics (usually intramuscularly 2-3 times a day), painkillers and diuretics. The doctor prescribes a course of antibiotics. When the condition improves, the patient is referred to a neurologist.

Treatment of meningitis is carried out under the strict supervision of medical workers

Poisoning

Acute headaches occur during poisoning due to intoxication of the body. In addition, the sick baby complains of nausea and weakness, and may experience abdominal pain. To alleviate the patient's condition, it is necessary to identify the source of toxins.

The further course of the disease in case of poisoning leads to diarrhea, vomiting and dehydration. Only restoration of normal fluid levels is the key to complete recovery. The baby must be shown to a doctor - if the body does not accept any food or drink, the patient will be prescribed IVs with saline solution.

Inflammation in the trigeminal nerve

Inflammation trigeminal nerve often provoked by the herpes virus, hypothermia. The pain differs in localization and severity from other diseases. The painful sensations are sharp, twitching in nature, as with pulpitis. This type of pain is called cluster pain. At the same time, lacrimation and drooling, and nasal discharge are observed. The attacks last for several minutes, then subside.

When the ophthalmic branch of the nerve is damaged, pain in the eyes begins. The pain is concentrated in the forehead and brow ridges. When you touch your face, the sensation intensifies. The child should be given a painkiller - Paracetamol (according to the instructions for use) - and go to an appointment with a neurologist.

Head injuries

One of the causes of headaches in children is head trauma. A child is constantly on the move; often he does not balance his strength and the strength of things with the true state of affairs. Green knees are a common occurrence for a primary school student whose every step is no longer watched by his mother.

If a head injury occurs, the child must undergo medical examination for concussion

The head sometimes suffers from falls and blows. If your baby complains of pain in the frontal, temporal or occipital region, feels dizzy and nauseous, or has poor coordination, you should immediately consult a doctor. The child needs to be kept at rest - a concussion can lead to serious consequences.

Vascular problems

If a child has chronic kidney, liver or heart disease, this provokes improper functioning of the blood vessels in the brain. Necessary at the first symptoms vascular disorders go to the clinic, since untreated dystonia has a chance to negatively affect the student’s heart rate and blood pressure. Signs vascular problems are:

painful sensations in the head;
shortness of breath with lack of air;
pain in the heart area (see also:);
fluctuations in blood pressure;
causeless change of mood;
slight increase in body temperature;
weakness;
impaired concentration.

If you have several symptoms from this list, you need to go to a neurologist. Such signs are observed for other reasons. Before visiting a doctor, you can put the patient to bed in a ventilated room.

To reduce pain, it is allowed to take Paracetamol in a dose appropriate to age and weight. More targeted treatment consists of getting rid of the underlying disease according to a regimen prescribed by a specialist.

Tumor in the brain

Most dangerous cause headache is tumor formation. The tumor may affect the brain or its membranes. Malignant disease blood sometimes metastasizes to the brain. Symptoms of this pathology are pain, accompanied by nausea and vomiting. It occurs mainly in the first half of the day.

Pain associated with other pathologies also gives the same symptoms. In any case, you urgently need to see a neurologist, who, if necessary, will give a referral to an oncologist. If the tumor is detected at an early stage, therapy is carried out without surgery.

Set of diagnostic measures

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Diagnosis begins with listening to the patient's complaints. The doctor asks parents and children why and when the pain occurred, about nausea, dizziness and other symptoms. The possibility of injury is identified.
The student is asked to talk about the atmosphere at school and the degree of workload - tests and tests were taken, how long he spent preparing for them. These questions are asked to identify possible overvoltage. The neurologist asks whether the baby had any stress.
Then the doctor checks the symptoms of the disease - measures the patient’s temperature and blood pressure, examines the head, throat, and neck. If necessary, the doctor prescribes other types of examination:
X-ray of the head and cervical spine;
MRI or CT scan of the neck and head;
blood analysis;
Analysis of urine;
cerebrospinal fluid analysis;
throat swab;
neurosonography;
electroencephalography;
consultation with an ophthalmologist, ENT specialist, dentist, pediatric neurologist, psychologist.

MRI of a child's brain
First aid for a child in emergency cases
The patient must be put to bed in a ventilated room. It is advisable to place a damp towel on your head. How home remedy“to calm the nerves” it is recommended to make a decoction of herbs – valerian or motherwort. If the pain is very severe, you need to give the patient a painkiller - Paracetamol or Nurofen in the dose suggested in the instructions for the medicine.
It would be a good idea to measure your child’s temperature and blood pressure. At reduced rates The patient should be given tea with lemon. After this, you need to call a doctor or emergency help at home.
Prevention
Prevention includes adherence to exercise and rest schedules, healthy eating, walks in the open air. The air in the apartment should be fresh. Adults should not smoke indoors. You need to pay attention to the psychological comfort in the family - sorting things out in front of the baby is unacceptable.
For prevention infectious diseases it is necessary to strengthen children, to accept cold and hot shower. It is necessary to ensure that the child does morning exercises every day and does not sit for a long time in front of the TV or computer during the day. Injury prevention includes playing sports that develop good coordination.

Acute or chronic headache is familiar to many people, in particular children suffer from it. Depending on the nature of the manifestations, the pain can be different: throbbing, sharp, aching, shooting, localized to one or another part of the head. Why does the occipital part of the child hurt, and how can we get rid of unpleasant symptoms in more detail?

There can be many reasons. It is not so scary if the child first developed pain due to overstrain of the muscles and soft tissues of the neck after a long stay of the head in one position. But, the occipital part is directly connected to the spine (cervical region) and the causes of pain can be more unpleasant. So, everything in order.

If a child complains of compression of the head, pain in the temples and forehead, then the reason may be increased intracranial pressure, changes in the blood vessels of the brain, or due to a recent sore throat or flu.

It is important to recognize the nature of pain in the back of the head in a child in time. If it intensifies when turning the head to the sides, or if it lasts for a long time, osteochondrosis (spondylitis) may develop.

If the neck muscles are tight, then this is a consequence of curvature of posture or muscle strain after being in an uncomfortable position for a long time. The child may simply be caught in a draft and the pain is a symptom that not everything is in order in the cervical spine.

Frequent causes of pain in the back of the head are brain injuries. If the child lost consciousness immediately after the blow, then this is a clear sign of head damage. Symptoms often go away quickly. The baby will cry a little, calm down and quickly forget about the trouble. But he may begin to be capricious again after some time, which should certainly alert parents, especially if the headaches are severe, and it is dark before the eyes.

The consequences of the blow did not pass without a trace, when the fontanel became swollen in infants, and the throwing of the head back and arching of the back became more frequent. If the baby has hit his head, then you need to lay him down, isolate him from bright light in the eyes and lightly rub the area of the bruise with your palms, apply a cold compress. Temporarily protect the child from unnecessary noise and active games. If nausea, vomiting, or signs of cerebral hemorrhages appear in children, of course, you need to see a doctor immediately.

Migraine. Increased pain during coughing and sneezing may indicate neuralgic diseases. The most common of them, even in childhood, is migraine.
Cordially – vascular diseases as a result of impaired blood circulation in the brain. Oxygen starvation occurs, a sharp narrowing of blood vessels occurs, blood pressure jumps, hypertension develops and, as its main symptom, pain in the back of the head. Hypertension can be triggered by a hereditary factor, a sudden change in weather, or a sleep disorder. With mild hypertension, the symptoms in children quickly disappear; all you need to do is take a walk in the fresh air, adjust your diet and sleep. If the case is severe and pain in the back of the head has become a constant phenomenon, then you need to see a neurologist and undergo the prescribed treatment (pathological changes in the vessels are possible).
Neuralgia, headache due to damage to the trigeminal nerve, strikes like an electric shock, often repeats, but quickly passes. When coughing, sneezing, sharp turns of the head intensify, the muscles on the face may twitch (contract involuntarily). Neuralgia occurs when there is a problem in the cervical spine, against the background of a cold, or an outbreak of an infectious disease. To eliminate troubles, warming, UHF, applying a bag of heated sand and warm compresses or cabbage (plantain) leaves are effective, and gauze moistened with juice is applied to the occipital area. It is good to give children an infusion of wormwood yarrow. Many problems with cervical vertebrae become a consequence of the child’s incorrect posture, which is important to teach children to monitor from early childhood. The neck is well supported by a bolster during sleep, which should be placed instead of a pillow, and the bed should also be firm enough.
Migraine, according to experts, is in most cases hereditary disease, usually transmitted from the mother. The likelihood of migraines in children is high if the mother herself suffers from it. This disease is associated with a lack of serotonin in the brain, which actually leads to throbbing pain, nausea and dizziness. It is hardly possible to completely cure migraines if they become inherited, but you can block and relieve attacks immediately upon their occurrence by ventilating the room more often and staying in the fresh air. Children can be given freshly squeezed potato juice (2 tablespoons 2-3 times a day), viburnum, black currant (juice), massage the head and back of the head.
Cervical osteochondrosis, abrasion of the vertebrae of the neck and intervertebral discs. The reasons for the development are a sedentary, sedentary lifestyle, smoking, excess weight, genetic predisposition, incorrect body position during sleep. Pain in the neck and back of the head. It is necessary to treat the disease; degeneration processes in the cervical spine in a child can ultimately lead to irreversible consequences.
Cervical spondylosis, there is deformation of the vertebrae in the neck, the appearance of osteophytes - growths that cause pain when turning the head, torment especially at night, and do not go away even at rest. From increased voltage in cervical area In addition to the pain in the back of the head, it puts pressure on the eyes and ears. The disease is more common in older people or those leading a sedentary lifestyle.
Cervical myositis, a manifestation of an inflammatory reaction in the muscles of the spinal skeleton, leading to damage to one of the groups of bones. This internal pathology, but with manifestations on the skin, regression of dermatomyositis is possible due to hypothermia, early injuries or muscle strains, or previous infectious diseases. It hurts first in the neck area, then begins to move to the back of the head. Only treatment at an early stage of the disease gives positive results. Based on the results of X-ray examination, anthelmintic, anti-inflammatory, antibacterial agents. Massage and physiotherapy are indicated.

Small children cannot express signs of anxiety in words; they simply begin to act up and cry. In fact, parents need to be attentive. Unpleasant sensations in the back of the head can be caused by a lack of air in the room, bright sound, light, and even staying in one position for a long time during sleep, when the neck muscles become numb. An irritating factor can be a TV, a loud sound, or aromatic candles placed in front of the baby’s crib. Aromatherapy has a powerful effect on the body and the effect should be relaxing and calming. But still, if the baby is capricious from the light directed into the eyes, and he doesn’t like it, then it’s better to remove it and take a closer look, maybe in silence and in the dark he will fall asleep faster.

Neck pain in a child may occur due to malocclusion and difficulty chewing food with improperly positioned teeth. This affects speech, gums, and pain in the back of the head. In addition, headache attacks occur in children under 5 years of age and can be triggered by taking certain foods. Foods high in nitrites and preservatives lead to vasoconstriction and spasms, ultimately leading to headaches in the back of the head. Harmful substances are found in food additives, for example, tyramine, sodium nitrite, which can cause headaches and low blood sugar. They have a bad effect on the brain and its functions and malfunction. If similar phenomena were observed in the mother during pregnancy, then there is a high probability that the child will suffer from headaches from birth.

In case of poisoning with poor-quality food (except for headaches), children may experience nausea, vomiting, and diarrhea due to indigestion. It is important to prevent dehydration, often give the child decoctions, tea with the addition of mint, St. John's wort, and elderberry. If the neck area hurts in attacks, then you can prepare an infusion of birch leaves by brewing 1 tbsp. 1 cup of boiling water, let it brew for 2-3 hours, apply to the affected area.

If the child is predisposed to the appearance of pain in the head and back of the head attacks, you need to exclude foods rich in carbohydrates from the diet, feed the child more often (up to 5 times a day), but in small portions.

Children are impulsive, emotional, and unable to cope with psychological problems and stress. Negative emotions negatively affect the brain, causing headaches that can be sharp, severe, monotonous or prolonged. Analgesics and sedatives do not always help to cope with pain during severe overexcitation.

It is hardly possible to protect your child from all negative factors affecting the brain from the outside, but the body must be constantly trained to develop protective reactions. A child should not keep fears, doubts and worries inside himself, but throw them out in time due to the groundlessness of such types of anxiety. It is important to explain this so that the baby believes and quickly calms down.

Headache (cephalgia) in children is observed quite often and can serve as the main, or even the only symptom of more than 50 different diseases. Cephalgia is any unpleasant sensation that occurs in the area from the eyebrows to the back of the head (the term is derived from the Greek words cephal- brain and algos- pain).

It is known that 80% of European adults suffer from headaches. It can be assumed that the prevalence of cephalgia among children is approximately similar. Before 7 years of age, 75% of patients experience migraine-type headaches; however, the most common type of cephalalgia is tension headache.

The classification of the International Headache Society includes the following cephalgia: migraine; GB voltage; cluster (bundle) headache and chronic paroxysmal hemicrania; headache not associated with structural brain damage; headache due to head injury; headache due to vascular diseases; headache due to intracranial non-vascular diseases; headache due to taking certain substances or their withdrawal; headache due to extracerebral infections; GB due to metabolic disorders; headache or facial pain due to pathology of the skull, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures; cranial neuralgia, pain due to pathology of nerve trunks and deafferentation pain; unclassifiable GB. All of these types of cephalgia can occur in children, although in practice migraines, tension headaches, and cluster headaches are more common.

In general, in the etiopathogenesis of cephalalgia, areas of the dura mater can serve as sources of pain; arteries of the base of the brain and intracranial arteries; tissues covering the skull; nerves (including cranial nerves - trigeminal, glossopharyngeal, vagus, as well as the first and second cervical spinal roots). Morpho-functional basis peripheral part The systems responsible for pain sensitivity are the trigeminal nerve and the nucleus of its spinal tract. The dura mater and large blood vessels, as well as the sensory endings of the fibers of the second cervical root of the spinal cord, have pain receptors. The described systems form various options headache .

Headache can be caused by intracranial lesions, such as subdural and intracerebral hematomas, subarachnoid hemorrhages, thrombosis, arteriovenous malformations, brain abscess, meningitis, encephalitis, vasculitis, obstructive hydrocephalus, post-lumbar puncture condition, ischemic disorder cerebral circulation, stretching or inflammation of large intracranial vessels, damage to the dura mater of the base of the brain and sensitive cranial nerves. Extracranial causes of headache include sinusitis, cervical spine injuries, temporomandibular joint syndrome, giant cell arteritis, glaucoma, optic neuropathy, and dental diseases. There are also “common” causes of headache: fever, viremia, hypoxia, hypercapnia, arterial hypertension, allergies, anemia, as well as the effect of vasodilators (nitrites, carbon monoxide etc.) .

The pathophysiological features of the three main types of headaches in pediatric patients are discussed below, since these features determine different approaches to treatment.

Migraine. Classic migraine is characterized by two phases of attack: in the first phase, vascular spasm occurs, causing cerebral ischemia and various focal symptoms, triggering an attack; in the second phase (transcranial and extracranial vasodilation), pulsating headache begins, which is distributed in the area of innervation of the trigeminal nerve and the upper cervical roots. In migraine with aura, the mechanism of headache development involves paroxysmal depolarization of neurons in the cerebral cortex. In the first phase of the attack, cortical depression spreading at a speed of 2 mm per minute is observed in the region of the occipital pole of the brain. In the area of wave propagation, profound changes in the ion distribution occur, leading to a decrease in the level of cerebral blood flow. Cerebral ischemia is the result of constriction of arterioles. Most characteristic feature classic migraine - general hypovolemia in the back of the brain. HD is caused by the effect of spreading depression on the trigeminal nerve fibers on the meninges, releasing vasoactive intestinal peptide, substance P and several other peptides. The factors that trigger the mechanism of spreading cortical depression are very numerous. These include any disturbances in potassium homeostasis, genetic predisposition, stress, nutritional factors, as well as the release of vasoactive peptides from the trigeminovascular system.

With simple migraine (without aura), there are no significant changes in cerebral blood flow, and the mechanisms of its development themselves are difficult to explain. In addition to vascular changes (characteristic of classic migraine), with simple migraine there are disturbances in metabolism and the concentration of neurotransmitters (serotonin and its metabolites).

The cause of migraines can be prostaglandin E1, tyramine or phenylethylamine (the latter two amines are found in chocolate and cheese).

Tension headache. Previously it was believed that this type of headache is a direct consequence of repeated contractions of the muscles of the neck and temples, leading to local ischemia of these structures. In recent years, a number of other links in pathogenesis have been considered, including the involvement of “trigger” points of certain muscles (trapezius, sternocleidomastoid, suboccipital, temporal, etc.), compression of blood vessels by a spasmodic muscle with venous stagnation, spread of pain to the temporal, parotid and occipital regions due to dysfunction of the temporomandibular joint, impaired closure of the teeth of the upper and lower jaws, etc.

Cluster headache. The pathogenesis of the disease has so far been little studied and is not entirely clear, although it is known that with this type of headache in the external jugular vein There is an increase in the content of some pain peptides (calcitonin gene-related and intestinal peptide). As a result, a neurogenic origin of cluster headache with activation of sensory fibers of the trigeminal nerve is assumed. A defect in the chemoreceptors of the carotid bodies on the side of pain, as well as disturbances in the secretion of certain humoral factors(melatonin, cortisol, testosterone, β-endorphin, β-lipoprotein, prolactin).

Symptoms of headache. In each specific case, the symptoms of headache are determined by the type of cephalgia present. Below are the characteristics of various types of chronic and recurrent headaches according to a number of indicators (nature, location, duration of attack, frequency, associated symptoms). Simple migraine: headache character is pulsating; localization - one- or two-sided; duration of attack - 6-48 hours; frequency - sporadic attacks (up to several times a month); accompanying symptoms are nausea, vomiting, malaise, photophobia. Classic migraine: headache character is pulsating; localization - one-sided; duration of attack - 3-12 hours; frequency - sporadic attacks (up to several times a month); accompanying symptoms are visual aura, nausea, vomiting, malaise, photophobia. Facial migraine: the nature of headache is dull or pulsating; localization - unilateral, in the lower half of the face; duration of attack - 6-48 hours; frequency - sporadic attacks; accompanying symptoms are nausea, vomiting. Cluster headache (Horton's histamine cephalgia): the nature of the headache is sharp, boring; localization - unilateral (mainly in the orbital area); attack duration - 15-20 minutes; frequency - periods of daily attacks alternate with long-term remissions; associated symptoms - on the side of pain, lacrimation, facial flushing, nasal congestion and Horner's sign may be noted. Psychogenic headache: the nature of the headache is dull, compressive; localization - diffuse bilateral; the duration of the attack is often constant; frequency - often constant; accompanying symptoms are depression, anxiety. Trigeminal neuralgia: the nature of the pain is shooting; localization - in the zone of innervation of the trigeminal nerve; the duration of the attack is short-term (15-60 seconds); frequency - many times a day; accompanying symptoms—trigger zones are identified. Atypical facial pain: the nature of headache is dull, localization is unilateral or bilateral, the duration of the attack is often constant; frequency - often constant; accompanying symptoms are depression, sometimes psychosis. Headache due to sinusitis: headache type - dull or acute; localization - one- or two-sided, in the area paranasal sinus; the duration of the attack varies; frequency - sporadic or constant; accompanying symptoms are nasal discharge.

Diagnostics. A specific diagnosis in children is established primarily on the basis of clinical signs and the above-mentioned criteria for cephalgic syndromes. So-called headache diaries, some laboratory and instrumental studies (x-ray of the skull, computed tomography and magnetic resonance imaging of the brain, EEG, transcranial Doppler examination of cerebral vessels) can help in diagnosis. Important diagnostic measure is a consultation with an ophthalmologist, and if a patient is suspected of having depression, a consultation with a child psychiatrist is required.

The diagnosis of migraine is usually made on the basis of a collected medical history, and no significant changes can be detected with a thorough physical, neurological and ophthalmological examination. Diagnosis of most other cephalgic syndromes is carried out using a similar algorithm.

Approaches to headache treatment

Not all drugs used in the treatment of hypertension in adults can be used in pediatric practice due to age restrictions. A classic example is analgin (metamizole sodium), which in world practice is not prescribed to children under 14 years of age (in the Russian Federation - up to 6 years). Another drug that should be used with caution in patients under 16 years of age is the non-narcotic analgesic naproxen (nalixan).

Below we list modern approaches to the treatment of three main cephalgic syndromes - migraine, cluster headache and tension headache.

Migraine treatment. Preventive treatment is carried out only for recurrent cephalgia that is resistant to the emergency treatment used. Migraine attacks should be treated only when we are talking about frequently recurring severe attacks that interfere with active life child. In some cases, one has to count on only a partial effect, although the administration of vasoconstrictors such as ergotamine and/or caffeine at the first symptoms of an attack can help stop it (in the Russian Federation, the drug caffeamine, which combines both of these components, is widely used). It is prescribed to children over 10 years of age twice, with an interval of 30 minutes, 1 tablet per dose (each tablet contains 0.1 g of caffeine and 0.001 g of ergotamine tartrate). The prescription of simple (non-narcotic) analgesics (paracetamol, etc.) is often no less effective.

In case of an acute attack of migraine, the regime must be combined with the use of analgesics: resting the child in bed (in a dark room) and taking paracetamol or acetylsalicylic acid. The latter is used with caution in pediatrics (in children under 2 years of age - only according to vital signs) to avoid the development of Reye's syndrome. It is paracetamol (at a dose of 15 mg/kg/day) that is the most effective and safe remedy, prescribed for migraine attacks of moderate to severe severity. Acetylsalicylic acid is effective only for mild attacks. Other drugs to treat severe attacks include naproxen, ibuprofen, phenacetin, or caffeine (alone or in combination with other drugs).

For children over 10 years of age, ergotamine is considered the drug of choice. It is prescribed orally at the very beginning of an attack (the dose depends on the type of dosage form, the duration of treatment should not exceed 7 days). The drug is contraindicated in children who have hemianopia or hemiparesis during the constrictor phase of an attack.

Phenacetin, like paracetamol, is a non-narcotic analgesic. It is used 2-3 times a day in combination with drugs such as analgin (taking into account age), caffeine, etc. Its use is limited due to the presence of side effects (allergic reactions, “phenacetin” nephritis, methemoglobinemia, anemia, etc. .) . Phenacetin is prescribed at the rate (single dose) of 0.15 g for 3-4 year old patients, 0.2 g for children 5-6 years old, 0.25 g for 7-9 year olds and 0.25-0 .3 g - for 10-14 year old children (for patients up to 1 year - 0.025-0.05 g, up to 2 years - 0.1 g per dose). In the Russian Federation, phenacetin is produced mainly in tablets containing 0.25 g of phenacetin itself and acetylsalicylic acid, 0.05 g of caffeine). Phenacetin is included in combined agents(asphen, cofitsil, novomygrofen, pirkofen, sedalgin, citramon, etc.).

Ibuprofen (Brufen) is a non-steroidal anti-inflammatory drug (NSAID). Children are prescribed at the rate of 20-40 mg/kg/day (3-4 times a day, per os or rectally).

Naproxen is another NSAID prescribed to children under 5 years of age at a dose of 2.5-5 mg/kg/day in 1-3 doses (duration of treatment course - up to 14 days), and to patients over 5 years of age - at a dose 10 mg/kg/day.

Caffeine is a psychomotor stimulant, used in combination with other medications (analgesics, etc.). For children over 2 years of age (before this age the drug is not prescribed), caffeine is dosed at 0.03-0.075 g per dose (2-3 times a day). Caffeine is part of combination tablets (caffetamine, askofen, novomygrofen, cofitil, pyramein, citramon, etc.).

Sumatriptan (a selective 5-HT1 receptor agonist) is effective in the treatment of migraine attacks in adults. However, sumatriptan does not offer any benefit over ibuprofen in treating children with migraine.

Preventive treatment. Propranolol for children is prescribed orally at an initial dose of 0.5-1.0 mg/kg/day 2 times a day, a maintenance dose of 2-4 mg/kg/day. In the presence of heart failure or bronchospasm, the drug is not used.

Flunarizine is a calcium channel blocker. Children weighing up to 40 kg are prescribed a dose of 5 mg once a day. For other categories of children, flunarizine is prescribed in the same way as for adults (20 mg 1 time in the first 2 weeks of preventive treatment, then 5-10 mg/day in 1-2 doses).

Anticonvulsants of the phenobarbital or valproic acid class can in some cases prevent an attack, but are prescribed only for frequently recurring attacks. Dosages for both anticonvulsants are selected individually (under the supervision of a physician).

Tricyclic antidepressants (amitriptyline, etc.) are rarely used to prevent migraines (more often these drugs are used for tension headaches).

Symptomatic remedies. For nausea and vomiting, metoclopramide (cerucal, raglan) is used at a dose of 0.5 mg/kg (intravenously, intramuscularly or orally). In this case, chlorpromazine (an antipsychotic from the group of phenothiazine derivatives) and prochlorperazine are also used.

Chlorpromazine. To achieve a quick effect, you can use up to 3 age-specific doses of the drug (intravenously) every 15 minutes. At parenteral administration in children older than one year, a single dose is 250-500 mcg/kg (the maximum dose in children under 5 years of age or with a body weight of up to 23 kg reaches 49 mg/kg/day, and at the age of 5-12 years or with a body weight of 23 -46 kg - 75 mg/kg/day). When administered orally to patients aged 1-5 years, the drug is prescribed in a daily dose of 500 mcg/kg (every 4-6 hours), children over 5 years old - from 1/3 to 1/2 the adult dose (a single dose for adults is 10- 100 mg, daily - 25-600 mg). Maximum dose for children under 5 years of age when taken orally - 40 mg per day, for patients over 5 years of age - 75 mg per day.

Non-drug treatments for migraines

Diet therapy. Since food allergies often play the role of a trigger factor for migraines in children, it is recommended to exclude a number of foods from the diet of a child suffering from migraines (milk, cheese, eggs, chocolate, oranges, products made from wheat and rye flour, tomatoes, etc.). Products with food additives such as monosodium glutamate and nitrites should be avoided.

Other non-drug approaches to the preventive treatment of migraine include wushu, karate, yoga, a biofeedback training system, and acupuncture.

Treatment of cluster headaches. Sumatriptan is widely used in the treatment of acute attacks of the disease. NSAIDs and ergotamine derivatives are considered less effective. Inhalation of pure oxygen is also included in therapeutic measures with the development of cluster headache attacks (inhalation of 100% oxygen).

Preventive treatment of cluster headaches involves the appointment of β-blockers (propranolol, etc.), carbamazepine, lithium preparations, as well as prednisolone (a course lasting no more than 5 days) and calcium channel blockers (verapamil). The dosage of propranolol is given above.

Carbamazepine (Tegretol, Finlepsin) is an anticonvulsant (iminostilbene derivative). Average daily dose of the drug (orally) is 20 mg/kg/day (on average in children under one year - 0.1-0.2 g, 1-5 years - 0.2-0.4 g, 5-10 years - 0.4 -0.6 g, 10-15 years - 0.6-1.0 g/day).

Of the lithium preparations, lithium carbonate (contemnol, sedalite) is most often used. This mood stabilizer is taken during meals with water or milk. At the same time, the lithium content in the blood is controlled, maintaining its concentration at 0.5-1.0 mmol/l. At a dose of lithium carbonate of 1.0 g/day, normalization of lithium concentration should be expected after 10-14 days. The course of preventive monotherapy with lithium carbonate preparations should be at least 6 months.

Prednisolone. If necessary, in the first days of treatment, this corticosteroid hormone is prescribed (per os) at the rate of 1-1.5 mg/kg body weight/day, then the dose is reduced and the drug is discontinued.

Verapamil (isoptin, phenoptin) is a calcium channel blocker. Taken orally during or immediately after meals (in 2-3 doses). The drug is taken with a sufficient amount of liquid. For children aged 1-15 years, the dosage is 0.1-0.3 mcg/kg/day (single dose no more than 2-5 mg).

Treatment of tension headaches. In this disease, the leading role belongs to the treatment of NSAIDs. In addition, a combination of NSAIDs with diazepam (Seduxen, Relanium) can be used. The latter is prescribed (when taken orally) in the following single dosage: 1-3 years - 0.001 g, 3-7 years - 0.002 g, 7 years and more - 0.003-0.005 g.

Tizanidine (sirdalud) - muscle relaxant central action, widely used in the treatment of tension headaches in adults. Experience with its use in children is limited.

Tricyclic antidepressants (amitriptyline, imipramine). Regardless of age and route of administration (orally, intramuscularly, intravenously), amitriptyline is prescribed from 0.05-0.075 g/day, gradually increasing the dose by 0.025-0.05 g until the effect is achieved. Imipramine (melipramine, imizin) is prescribed to children starting from 0.01 g 1 time per day, gradually (over 10 days) the dose is increased to 0.02 g for children 1-7 years old, to 0.02-0.05 g for children 8-14 years of age (patients over 14 years old - up to 0.05 g or more per day).

Literature

Yakhno N. N., Parfenov V. A., Alekseev V. V. Headache: A reference guide for doctors "R-Doctor". Series "Nosology". M., 2000. 150 p.
Chu M. L., Shinnar S. Headaches in children younger than 7 years of age // Arch. Neurol. 1992. vol. 49. P. 79-82.
Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain // Cephalalgia. 1988. V. 8. Suppl. 7.96 p.
Goadsby J. P. Update of the anatomy and physiology of headache // Abstr. of 2-d Congress Eur. Fed. Chapt. of IASP. Barcelona. 1997. P. 79.
Therapeutic reference book of the University of Washington / Ed. M. Woodley, A. Whelan; lane from English M.: Practice. 1995. 832 p.
Dalessio D. J. Wolff's headache and other head pain. Oxford University Press. New York. 1980.
Oleson J., Edvindsson L. Migraine: a research field matured for the basic neurosciences // Trends Neurosci. 1991. Vol. 14. P. 3-5.
Lauritzen M. Pathophysiology of the migraine aura. The spreading depression therapy //Brain. 1994. Vol. 117. P. 199-210.
Ferrari M. D. Cerebral blood flow during migraine attacks without aura and effect of sumatriptan // Arch. Neurol. 1995. Vol. 52. P. 135-139.
Congden P. J., Forsythe W. I. Migraine in childhood: a study of 300 children / /Dev. Med. Child Neurol. 1979. Vol. 21. P. 209-216.
Neurology/Ed. M. Samuels; Per. from English M.: Practice. 1997. 640 p.
Child Neurology (Menkes J.H., Sarnat H.B., eds.).-16th ed. Lippincott Williams and Wilkins. Philadelphia-Baltimore. 2000. 1280 p.
Vidal Directory. Medicines in Russia: Directory. 8th ed., revised. and additional M.: AstraPharmService. 2002. 1488 p.
Hamalainen M. L. Ibuprofen or acetaminophen for the acute treatment of migraine in children. A double-blind, randomized, placebo-controlled, crossover study // Neurology. 1997. Vol. 48. P. 103-107.
Mashkovsky M.D. Medicines. In 2 hours. 12th ed., revised. and additional M.: Medicine. 1993.
Register medicines Russia "Encyclopedia of Medicines" / Ch. ed. G. L. Vyshkovsky. 9th ed., revised. and additional M., RLS-2002. 2002. 1504 p.
Hamalainen M. L., Koppu K., Santavuori P. Sumatriptan for migraine attacks in children: a randomized, placebo-controlled study // Neurology. 1997. Vol. 48. P. 1100-1103.
Egger J. Is migraine a food allergy? // Lancet. 1983. Vol. 2. P. 865-869.
Wilkinson M. Migraines and headaches / Transl. from English K.: "Sofia". 1997. 112 p.
Clinical recommendations based on evidence-based medicine/ Per. from English edited by I. N. Denisova, V. I. Kulakova, R. M. Khaitova. M.: GEOTAR-MED, 2001. 1248 p.