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

Headache complaints are not uncommon in children and adolescents. These can be isolated cases or recurring attacks, but in any case, a headache (cephalgia) in a child should not be ignored by parents and doctors, as it can be a sign of a serious illness.

The brain tissues do not have pain receptors directly, 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 - 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, cephalgia is often long time remains unrecognized, as small patients cannot formulate their complaints.

Possible causes of headaches in children:

migraine;
malignant and benign neoplasms of the brain;
inflammatory diseases of the central nervous system (central nervous system) - 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, chemical active substances, organic poisons, carbon monoxide and more. others);
craniocerebral 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 states;
pathology 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 feature of the course of cephalalgia in infants and children under 3-4 years old is that often the child cannot express his complaints.

The most common cause of pain syndrome becomes hydrocephalus, intoxication, congenital pathologies of blood vessels and brain tissues 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, aggravated by a change in the position of the body and head, noise and light stimuli;
spontaneous screams and shudders;
frequent regurgitation and vomiting;
bulging and pulsation of the fontanel;
stiffness of the body and limbs;
head tilt, etc.

Such symptoms should not be ignored by parents and serve as a reason for immediate medical attention.

Headache in children 6-10 years old and adolescents

Cephalgia in children of this age category can have an acute paroxysmal and chronic character and is a sign of various diseases. Consider the most common causes of headaches.

Vascular cephalgia- is a symptom of such diseases as (vegetative-vascular dystonia), hypotension, hypertension, dyscirculatory encephalopathy, etc. Characteristic are pulsating, dull, aching, bursting headaches, often localized in the occipital region. Cephalgia is accompanied by nausea, darkening of the eyes, dizziness, pallor of the 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 the life of a child. The disease is characterized by attacks of acute throbbing headache lasting up to 2-3 hours. Often, the onset of an attack is foreshadowed 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 unilateral and bilateral in nature, accompanied by vomiting, which brings relief.

Tension headache It is most common in children of school and adolescence. Its occurrence is associated with psycho-emotional overstrain, incorrect position of the body and head when sitting at a desk, computer desk, excessive visual load (long-term presence of a child in front of a TV, monitor), incorrect spectacle correction of visual impairment, stress, excessive physical exertion. The headache is compressive in nature, has no clear localization, 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, various neurological disorders. The pain is characterized by high intensity, increases with a change in the position of the child's body, exposure to light, tactile and noise stimuli. In severe cases of the disease, the child is in the "pose of a pointing dog" - on its side, with bent limbs brought to the body and its head thrown back. These symptoms are grounds for immediate medical attention. 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, visual impairment. In severe cases, an attack may be accompanied by convulsions and loss of consciousness.

Psychogenic cephalgia may be paroxysmal (lasting up to 2 weeks) and permanent. Most often, psychogenic cephalgia affects children 8-13 years old. Pain is moderate, dull, squeezing, without a clear localization. Various stressful, conflict situations provoke the onset of an attack.

First aid for a headache in a child

First of all, you need to find out the cause of the headache. If the disease that caused cephalgia is known (ARVI, otitis media, sinusitis, etc.), then proper treatment the main pathology will save the child from headaches. In addition, parents can take measures to ease the attack of cephalalgia:

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

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

high intensity of pain;
attacks of cephalalgia more than 1 time per month;
night and morning pain;
concomitant symptoms: dizziness, nausea and vomiting, visual impairment, mental changes, impaired consciousness, coordination, sensitivity, etc .;
meningeal signs - hyperthermia, "posture of a pointing dog", convulsions, loss of consciousness, neurological symptoms.

Diagnosis of causes of headache

In each case of paroxysmal or chronic cephalalgia in children, it is necessary to find out its cause. Only a qualified medical 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, anamnesis of life and illness.

In the future, consultations of other specialists (neuropathologist, 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 - UZDG (ultrasound dopplerography), EchoEG (echoencephalography), duplex scanning, etc.;
radiological studies - SPECT (single photon emission computed tomography), PET (positron emission tomography), etc.

Parents of children complaining of a headache should not delay a visit to the attending physician. Indeed, early diagnosis and timely treatment are the main guarantee of successful treatment of all diseases that cause cephalgia in a child.

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

note

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

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

Headache in a child: does it always indicate a pathology?

For headaches with early childhood many organic and functional causes have been identified, and this 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 about headaches. You can find out both the nature of pain sensations, and localization, features of the symptom. After a short questioning, you can find out in what situation and after what events the pains arose, and if they are repetitive, than they are usually provoked. You can also check with children, due to which their pain is relieved or completely disappears.

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

For better understanding of all the processes that can occur in the head of a child, as well as to facilitate understanding of the causes of the development of pain and its origin, it is important to at least briefly analyze 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 zones of the head have pain receptors that can form pathological impulses. The areas of the venous sinuses, the cranial nerves and the area of the meninges are rich in pain receptors, in addition, the large vessels of the head, the periosteum or soft tissues in the skull area. In addition, pain receptors are supplied to all large vessels of the neck and facial tissues, which can also form pain impulses with reflected signals.

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

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

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 "cephalgia", but any unpleasant, subjectively uncomfortable sensation in the head area can fall under this definition. Because of this, the concept of cephalgia includes both a feeling of heaviness and unsharp pains, as well as the sharpest, sharpest and most excruciating pain sensations.

According to their localization, it is customary to rank sensations that occur over the entire area, starting from the superciliary arches and up to the border where the back of the head passes into the neck (the place where the skull is attached to the spine) as cephalic pains.

In children, headaches are formed due to various reasons associated both with the bone formations of the skull themselves, and with its vessels or nerve endings and trunks, all the meninges, its additional structures. Headaches may also develop due to various violations in the area of the cervical spine, as well as disorders in the work of the shoulder girdle, pathology of internal organs, tissues, or the whole organism.

note

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 the receptors in the head area (often also the neck) and give pain, which is interpreted as headaches.

Types of headaches in childhood

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

If headaches are 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, he has pronounced ailments, then we are talking about pain . Such pain may be typical for various processes- microbial, viral infections. In addition, these types of pain - primary, are typical for, beam or cluster pains, or tension headaches.
if headaches are one of many other extremely unpleasant symptoms, they are . Then these complaints are not classified as 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 kinds infections, febrile reactions, which will gradually disappear as the condition normalizes or the fever is eliminated.

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

Causes of children's cephalgia

Of course, to list all possible situations, in which headaches are possible in children, is practically 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 at once, a combination negative factors and problems on the part of the body, the impact of external and internal influences. But among the whole variety of processes leading to cephalalgia in childhood, the most frequently occurring and strongly affecting causes can be distinguished.

The most common and frequently recorded causes for the formation of pain in childhood:

Consequences arising after or bruises, falls or blows
Reactive reactions that occur in response to drastic changes environmental factors - temperature fluctuations, precipitation or changes in the geomagnetic situation
Secondary pains of a reactive nature, which are 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 some medical manipulations
Reactions to infectious agents, taking certain medications or dietary supplements, certain types products, as a consequence of dehydration or a response to the problematic work of certain internal organs (kidneys, liver, heart).
Pain sensations that form inflammation processes localized in the paranasal sinuses (, ethmoiditis or, pansinusitis)
Pain arising from overdose, which were used without indications for them
Headaches associated with tension, if children are strong on the background of prolonged mental stress, prolonged sitting at the monitor
, which differ significantly in severity and duration, as well as the type of pain sensations, or cluster headaches that rarely occur in adolescents, which have not yet been precisely clarified in origin.

The occurrence of any child's complaints about headaches, even minimal and not acute, localized in the temples, frontal zone or occiput, should be a reason for consulting a doctor, especially if there are no signs of a cold, somatic infections, and headaches are repeated repeatedly.

Features of cephalgia depending on age

Headaches are possible in any age group children, including among newborns, but it is in the latter that it is most difficult to diagnose such symptoms. This is due to a complex of non-specific behavioral reactions in response to pain impulses and the inability to verbally express their feelings. It is often very difficult for a doctor and parents to determine the exact localization of pain sensations and their strength. There are certain age-related features in the development of cephalgia, and the most typical causes sensations:

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

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

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

Tension headaches: what is special in children

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

Mechanism similar pains, especially those associated with stress, is relatively simple. The process of active and pronounced contraction of muscle elements in the head area is formed. This is especially reflected in the vessels, which are also reduced. Vessels located in the head and neck area, which, due to muscle contraction, come into a state of spasm, form irritation of pain receptors, as a result, they give a feeling of headache.

On average, the duration of such pain can range from a couple of hours to several days or even weeks, it all depends on which of the factors affect the receptors. These pains are described as a sensation of constriction or constriction of the head with a hoop, a sensation sudden pressure in the area of the neck, temples or neck. At the same time, sensations can be formed inside the head that are similar to the state of “putting on a helmet or helmet”. The intensity of pain is not very high, in view of which the child remains able to work and can perform daily activities, his work capacity and psyche do not suffer, but the learning process and concentration of attention, behavior may suffer.

What is special about these headaches?

With them, painful sensations can intensify during physical exertion or emotional experiences, and at the peak of an attack, nausea occurs with refusal to eat, intolerance to light and sounds, increased pain from strong stimuli of the sense 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 may occur with vision problems, due to the tension of the visual analyzer.

Vascular pain: features in children

In order for the brain of a child, 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 nutrients through cerebral vessels. Due to various pathologies, dysregulation of vascular tone, prolonged stress or other factors, cerebral vessels spasm or stretch excessively. As a result, blood either flows poorly to the brain or flows out of it with difficulty, which leads to a disruption in the supply of oxygen. The brain reacts quite sharply and sharply to such changes, which forms headaches. Such problems are typical for schoolchildren and adolescents, which in the future may result in manifestations (VSD).

Changes in intracranial pressure: features of children

Change in CSF pressure (this is cerebrospinal fluid circulating around the brain) is possible in normal conditions against the background of physical activity and stress, with a strong cough 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 beyond certain physiological values if symptoms of malaise occur, it is necessary to consult a doctor in order to exclude 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. Against the background, the condition is always bad, but worsening occurs in the late afternoon or at night. Typical for intracranial hypertension are nausea, leading to, which at the same time does not alleviate the condition, and does not reduce pain.

Headaches with ICP are localized in the back of the head, are formed discomfort in the zone of the orbits, which is formed due to excessive pressure on the area of the orbits. 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 reduced intracranial pressure - this is formed against the background of intestinal infections or injuries, but up to five years of age, it is difficult to determine such symptoms of headaches, babies cannot accurately describe their feelings. You can indirectly guess about such a symptom by the presence of apathy and drowsiness, lethargy and weakness, as well as bouts of dizziness or even loss of consciousness. The nature of the headaches is dull and pressing, usually they are localized in the back of the head.

Headache due to infectious diseases

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 diseases - fever of varying severity, pain in the throat, or chills, bouts of nausea or vomiting. Based on all these symptoms, in combination with indications of contact with people with colds, it is easier to diagnose children, as well as to identify the cause of pain in the head.

A special option is a headache against a meningococcal lesion with suspicion of. It is typical for children at an early age, in the first year of life, as well as in preschoolers and schoolchildren. Typical fever and the formation of a severe headache, which are then gradually joined by vomiting, which has nothing to do with nutrition, and will not bring relief to children. General state children are rapidly and progressively disturbed, due to changes in intracranial pressure and inflammation of the tissues, children take forced postures with bringing the legs to the chest and tilting the head back. This condition is especially dangerous if dots appear on the skin of the body that look like needle pricks or bruises, stars.

Pathologies of the nervous system in childhood

Frequent sharp and acute headaches that do not have other manifestations, are poorly stopped by analgesics, and their symptoms are atypical 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 or to evaluate visually anatomical formations in the brain area. They can give a severe and painful headache, hemorrhages with the formation of hematomas, cystic cavities,. They form a change in the anatomy inside the skull, which threatens to change the intracranial pressure. Typical manifestations of such problems are a severe and excruciating headache 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 baby has headaches at an early age, this is due to the fact that the child cannot speak and write his complaints in detail. Symptoms such as anxiety and crying, sleep disturbances can indirectly indicate health problems and headaches, provided that the child is fed, it is dry and not visible reasons for irritation. If all the reasons for the child's discomfort are eliminated, but at the same time he constantly cries, screams, a neurologist's consultation is necessary. There are certain indirect signs for which you can suspect headaches in babies:

Screams and anxiety, prolonged crying intensify in the evening, increased screams when changing the position of the body, moving the crumbs from a vertical to a horizontal position and vice versa.
The veins on the head swell strongly, bulge and are very tense
The sleep process suffers, the child falls asleep with screams or sleeps very badly both during the day and at night.
There may be sharp cries, shuddering, groaning.
He can pull the handles to the head, pull his hair
There may be frequent regurgitation of large amounts of food, vomiting
Loss of appetite up to complete refusal of food
Often there is fever, sweating
The child is pale, drowsy, apathetic.
There may be violations of muscle tone, stiffness of 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, cerebrospinal fluid spaces, intoxication syndrome and infection.

Headaches in babies from 2-3 to 5-6 years

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

Irritability and whims of the child, constant crying for any reason
Attempts to put 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
Nausea with vomiting, sweating and dizziness
The child points to the head and complains of pain, but cannot accurately indicate the location or character.

The causes of pain at this age are usually infections, somatic pathologies, toxicosis, the 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 after 6 years of age, headaches are approximately comparable in their characteristics to adults, the child can already accurately and adequately assess the localization, strength and nature of pain. At this age, headache can be acute or chronic, paroxysmal or persistent. 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 (VVD), as well as migraine or pain as a result of tension.

Less commonly, pain occurs as a result of inflammatory, neoplastic, or traumatic lesions the nervous system itself, which requires emergency consultation at the neurologist. There may be options for psychogenic headaches in adolescence, which can be long and persistent. They are provoked by problems in the family, stress, conflicts with peers.

What to do with a headache in a child?

Naturally, the elimination of the cause of pain and the treatment of the underlying disease in most cases leads to the elimination of an unpleasant symptom. But while the causes are being clarified, or if there are extremely unpleasant symptoms of pain, you can help to alleviate the condition of the baby. To reduce the intensity or completely eliminate the attack, apply:

Usually, such methods are enough to eliminate headaches, they disappear 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 the ambulance will be severe excruciating and unbearable pain, vomiting and dizziness, inappropriate behavior of the child.

It is important to have a baby examined at any age if:

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

Diagnosis and treatment of cephalgia in children

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

Can be appointed to find out the true causes of a whole glad 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 kinds 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 cephalgia. If these are episodic tension pains, or seizures caused by overloads, some influences, you can do without medication - you need to change the daily regimen, reduce stress and good rest, sleep of the child, his long stay on fresh air. Sedative and sedative teas and decoctions, infusions, rationalization of the regime of work and rest, rejection of prolonged static loads, TV and computer can help.

Alena Paretskaya, pediatrician, medical commentator

Children get headaches various reasons. In babies under 2 years of age, malaise is most often accompanied by fever, which indicates an infectious disease. In schoolchildren, strong pain sensations in the region of the back of the head and crown appear with serious mental and physical stress, improper diet and violation of the daily regimen. Pain can also be localized in the frontal region or in the region of the temples. If the temperature rises, you need to call a doctor at home, as well as visit a neurologist.

Headache in a child can be a sign of a serious illness

The main causes of headaches in children

When a baby complains of a headache, it is necessary to find out the background of the phenomenon. The cause of the pain is initially determined by location, but the same localization of pain sensations indicates various diseases. Only a specialist can diagnose and prescribe treatment.

Migraine

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

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

Often headaches in children due to migraines are hereditary disease. The pain comes on paroxysmal. Whiskey hurt from a few minutes to several hours. After vomiting, the child becomes much easier. Painkillers don't help. Appears before the attack general weakness and intense thirst, loss of appetite. Sometimes the patient feels dizzy up to loss of consciousness.

Vegetative-vascular dystonia

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

VSD is a frequent occurrence in children with an increased level of mental activity - choleric. 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 the rest and sleep regimen, violation of proper nutrition, quarrels and troubles in the family and school. To reduce the risk of VSD, preventive measures should be followed.

overvoltage

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

overstrain of a student during exams or before tests, tests;
violation of the regime of the day with a decrease in the time of night sleep;
stressful situations at home or at school;
incorrect body position during sleep;
stay in a stuffy room;
long time spent at the computer or watching TV;
starvation;
weather change.

The mechanism of occurrence of pain for these reasons is different. The first is muscle tension, leading to a certain inflammatory response. In this case, the vessels expand and release into the blood a substance that irritates the pain centers. The second mechanism is a violation of 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 disturbed.

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

The pain is localized in the temples and in the frontal part, sometimes in the region of the crown. It is of a constrictive nature. The syndrome continues 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 muscles ache at the same time as the head, soreness is felt in the abdomen or the region of the heart. The child complains of weakness, his appetite disappears, sleep is disturbed.

Diseases of the ENT organs and eyes

Often the cause of headaches are diseases of the upper respiratory tract or ophthalmic diseases. The essence of the phenomenon lies in the fact that with inflammation of the throat or sinuses, as well as with the pathology of the eyeball, pain receptors are influenced by irritating and toxic factors. If the eye is inflamed, then in addition to the pain in the head, there is pain in the eye sockets, tearing. With inflammation of the sinuses on the cheeks, an unhealthy blush occurs.

Pain reliever for inflammatory diseases nose, throat, ear and eye is the treatment of the underlying disease. With such pathologies, the baby may have a fever. It is necessary to call a doctor at home or go with the child to the pediatrician on your own.

A child's head may hurt during a cold

Unstable intracranial pressure

Intracranial pressure in a healthy child increases due to heavy physical exertion, when coughing, when lifting weights. After the cause is eliminated, the pressure returns to normal and does not require treatment. Headaches in the back of the head with an increase indicate pathology. The main symptoms of this are:

nausea and vomiting, headache;
deterioration 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;
night sleep disturbance.

Intracranial pressure decreases due to head trauma, poisoning, dehydration. If the child is small, it is difficult to understand where the pain is concentrated. Attention should be paid to concomitant symptoms- lethargy, apathy, loss of appetite, drowsiness, dizziness. Older children determine the dull and pressing nature of 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 is easy to identify by additional signs - fever, cough, runny nose, sore throat.

Rhinovirus infection is accompanied by clear discharge from the nose. Influenza begins with a rise in temperature up to 40 degrees. In this case, the patient feels aching joints and soreness of the skin. Adenovirus infection leads to damage to the eyes or intestines (we recommend reading:).

Viral infections are treated by a pediatrician or infectious disease specialist. Pain in the head disappears when the disease subsides. A visit to the doctor is necessary because he knows what kind 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 soreness of the skin. Sensations are aggravated by bright light, noise and sudden movements. The headache is localized in the forehead. Sometimes it affects the temples or is herpes zoster.

The patient's typical posture is lying on his side with his knees tucked under his stomach, his head thrown back. Forcibly turn the child into another position should not be. Seizures are possible.

Meningitis is treated in a hospital. With an increase in temperature and the presence of the above symptoms, 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 professionals

Poisoning

Acute headaches occur when poisoning due to intoxication of the body. In addition, a sick baby complains of nausea and weakness, he may experience pain in the abdomen. 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 the restoration of a normal fluid level is the key to a complete cure. The baby must be shown to the doctor - if the body does not accept any food and drink, the patient will be prescribed droppers with saline.

Inflammation in the trigeminal nerve

Inflammation trigeminal nerve often provokes the herpes virus, hypothermia. Pain at the same time differ in localization and strength from other diseases. Painful sensations are acute, jerking in nature, as with pulpitis. Such pain is called cluster pain. At the same time, there is lacrimation and salivation, nasal discharge. Attacks proceed some minutes, then subside.

When the ophthalmic branch of the nerve is damaged, pain in the eyes begins. The pain is concentrated in the region of the forehead and superciliary arches. When touching the face, the sensations intensify. The child should be given an anesthetic - Paracetamol (according to the instructions for use) - and go to see a neurologist.

Head injury

One of the causes of headaches in children is head injuries. The child is constantly on the move, often he does not measure his strength and strength of things with the true state of affairs. Green knees are a common thing for a primary school student, whose mother no longer follows every step.

If a head injury occurs, the child should be medical examination for a concussion

When falling and hitting, the head sometimes suffers. If the baby complains of pain in the frontal, temporal or occipital part, he is dizzy and nauseous, coordination is impaired, you should immediately consult a doctor. The child needs to ensure peace - a concussion leads to serious consequences.

Vascular problems

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

pain in the head;
shortness of breath with lack of air;
pain in the region of the heart (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 the doctor, you can put the patient to bed in a ventilated room.

To reduce pain, it is allowed to take Paracetamol in a dose corresponding to age and weight. A more targeted treatment consists in getting rid of the underlying disease according to the scheme prescribed by the 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 morning.

The same symptoms give pain associated with other pathologies. In any case, you need to urgently 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 surgical intervention.

A set of diagnostic measures

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Diagnosis begins with listening to the patient's complaints. The doctor asks the parents and children why and when the pain arose, 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 - there were tests and tests, how long he had been preparing for them. Such questions are asked to identify possible overvoltage. The neurologist is interested in whether the baby had stress.
Then the doctor checks the symptoms of the disease - measures the patient's temperature and pressure, examines the head, throat, neck. If necessary, the doctor prescribes other types of examination:
x-ray of the head and cervical spine;
MRI or CT of the neck and head;
blood test;
Analysis of urine;
analysis of cerebrospinal fluid;
throat swab;
neurosonography;
electroencephalography;
consultation of an ophthalmologist, ENT, dentist, pediatric neurologist, psychologist.

MRI of the child's brain
First aid for a child in an emergency
The patient must be put to bed in a ventilated room. It is advisable to put 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 strong, you need to give the patient an anesthetic - Paracetamol or Nurofen at the dose suggested in the instructions for the medicine.
It will not be superfluous to measure the child's temperature and pressure. At reduced rates give the patient tea with lemon. After that, you need to call a doctor or emergency care at home.
Prevention
Prevention includes the observance of the regime of classes and rest, healthy eating, walks in the open air. The air in the apartment must be fresh. Adults must not smoke indoors. It is necessary to pay attention to the psychological comfort in the family - it is unacceptable to sort things out with the baby.
For prevention infectious diseases it is necessary to temper children, to take cold and hot shower. It is necessary to ensure that the child does morning exercises every day, does not sit during the day for a long time in front of the TV or computer. Injury prevention includes playing sports that develop good coordination of movements.

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

There can be many reasons. It is not so scary if the child has pain for the first time 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 with the spine (cervical region) and the causes of pain can be more unpleasant. So, everything is in order.

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

It is important to recognize the nature of pain in the back of the head in a child in time. With its strengthening when turning the head to the sides, a protracted course may develop osteochondrosis (spondylitis).

If the muscles of the neck are compacted, then this is a consequence of a curvature of the posture or overstrain of the muscles after a long stay in an uncomfortable position. The child may simply be blown away in a draft and pain is a symptom that not everything is in order with the cervical spine.

Common causes of back pain are brain injuries. If the child lost consciousness immediately after the impact, then this is a clear sign of damage to the head. Often the symptoms pass quickly. The baby will cry a little, calm down and quickly forget about the trouble. But it can again begin to act up after some time, which should certainly alert parents, especially if the pain in the head is severe, it is dark before the eyes.

The consequences of the blow did not go unnoticed, when the fontanel of the infants swelled up, the tilting of the head back with arching of the back became more frequent. If the baby has already hit his head, then you need to lay him down, isolate him from bright light getting into his eyes and lightly rub the bruised area with his palms, apply a cold compress. For a while, protect the child from unnecessary noise, outdoor games. With the appearance of nausea, vomiting, signs of cerebral hemorrhage in children, of course, you need to see a doctor immediately.

Migraine. Increased soreness during coughing, sneezing may indicate neuralgic diseases. The most common of them, and even in childhood, is migraine.
Cardio - vascular diseases as a result of circulatory disorders in the brain. Oxygen starvation occurs, a sharp narrowing of blood vessels, blood pressure jumps, hypertension develops and, as its main symptom, pain in the back of the head. A hereditary factor, a sudden change in weather, and a sleep disorder can provoke hypertension. With mild hypertension, the symptoms in children quickly pass, it is enough just to take a walk in the fresh air, adjust the diet and sleep. If the case is severe and the pain in the back of the head has become a constant phenomenon, then you need to see a neurologist, undergo the prescribed treatment (pathological changes are possible in the vessels).
Neuralgia, headache due to damage to the trigeminal nerve, strikes like a current, often repeated, but quickly passes. When coughing, sneezing, sharp turns of the head intensifies, the muscles on the face can twitch (involuntarily contract). Neuralgia occurs when there is a malfunction in the cervical spine, against the background of a cold, an outbreak of an infectious disease. To eliminate troubles, warming up, UHF, applying a bag of heated sand and warm compresses or cabbage leaves (plantain) are effective, and gauze moistened with juice is rare to the occipital region. It is good to water children with infusion of wormwood yarrow. Many problems with cervical vertebrae are the result of the child’s incorrect posture, which is important to teach children from early childhood. The neck is well supported by the roller during sleep, which should be placed instead of a pillow, and the bed should also be hard enough.
Migraine, according to experts, is in most cases hereditary disease usually passed down from the mother. The likelihood of migraine 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 pains, nausea and dizziness. It is hardly possible to completely cure migraine if it is inherited, but it is possible to block and relieve attacks immediately upon occurrence: by ventilating the room more often, being in the fresh air. Children can be given freshly squeezed potato juice (2 tbsp. 2-3 times a day), viburnum, black currant (juice), massage the head and the 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 everything, a genetic predisposition, incorrect body position during sleep. Pain in the neck and back of the head. It is necessary to treat the disease, the processes of degeneration in the cervical spine in a child can eventually lead to irreversible consequences.
Cervical spondylosis, there is a deformation of the vertebrae in the neck, the appearance of osteophytes - growths that cause pain when turning the head, torment especially at night, do not go away even at rest. From high voltage cervical area in addition to pain in the back of the head, it presses on the eyes and ears. More often the disease occurs in older people or leading a sedentary lifestyle.
Cervical myositis, a manifestation of an inflammatory reaction in the muscles of the skeleton of the spine, 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, and 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. According to the results of x-ray examination, anthelmintic, anti-inflammatory, antibacterial agents. Shown massage, physiotherapy.

Young children cannot express signs of anxiety in words, they just begin to act up and cry. In fact, parents need to be careful. A lack of air in the room, a bright sound, light, and even a long stay during sleep in one position, when the neck muscles become numb, can cause discomfort in the back of the head. An irritant factor can be a TV, a loud sound or aroma candles placed in front of the baby's bed. Aromatherapy has a powerful effect on the body and the effect should be relaxing, soothing. But still, if the baby is naughty from the light directed into the eyes, and he does not like it, then it is better to remove it and take a closer look, maybe it is in silence and in the dark that he will fall asleep faster.

Neck pain in a child may be due to malocclusion and difficult chewing of food with the wrong arrangement of teeth. This is reflected in speech, gums, and pain in the back of the head is also manifested. In addition, headache attacks occur in children under 5 years of age, and can be triggered by the intake of certain foods. Foods high in nitrites and preservatives lead to vasoconstriction and spasm, resulting in a headache in the back of the head. Harmful substances are found in food additives, for example, tyramine, sodium nitrite, which can cause headaches, lower blood sugar. They have a bad effect on the brain and its functions, they fail. If such phenomena were observed in the mother during pregnancy, then it is highly likely that the child will suffer from headaches from birth.

In case of poisoning with low-quality food (except for a headache), children may experience nausea, vomiting, diarrhea due to indigestion. It is important to prevent dehydration, give the child more often decoctions, tea with the addition of mint, St. John's wort, elderberry. If the neck area hurts with attacks, then you can prepare an infusion of birch leaves by brewing 1 tbsp. 1 cup 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 neck with seizures, carbohydrate-rich foods should be excluded from the diet, the child should be fed more often (up to 5 times a day), but in small portions.

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

It is hardly possible to protect your child from all the negative factors affecting the brain from the outside, but you need to constantly accustom yourself to developing protective reactions of the body. The child should not keep fears, doubts and experiences in himself, but splash 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 discomfort that occurs in the area from the eyebrows to the back of the head (the term is derived from the Greek words cephalus- brain and algos- pain).

It is known that headache (HA) affects 80% of adult Europeans. It can be assumed that among children the prevalence of cephalgia is approximately the same. Up to 7 years of age, 75% of patients have a migraine-type headache; however, the most common type of cephalalgia is tension headache.

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

In general, in the etiopathogenesis of cephalgia, 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 (among them cranial nerves - trigeminal, glossopharyngeal, vagus, as well as the first and second cervical spinal roots). Morpho-functional basis peripheral department The systems responsible for pain sensitivity are the trigeminal nerve and the nucleus of its spinal tract. Pain receptors are possessed by the dura mater and large blood vessels, as well as sensitive endings of the fibers of the second cervical root of the spinal cord. 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, lumbar puncture condition, ischemic disorder cerebral circulation, stretching or inflammation of large intracranial vessels, damage to the hard shell of the base of the brain and sensitive cranial nerves. Of the extracranial causes, headache is caused by sinusitis, injuries of the cervical spine, 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 action of vasodilators (nitrites, carbon monoxide etc.) .

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

Migraine. Classical migraine is characterized by two phases of an attack: in the first phase, a vascular spasm occurs, causing cerebral ischemia and various focal symptoms triggering an attack; in the second phase (transcranial and extracranial vasodilation), pulsating GB begins, which is distributed in the region of innervation of the trigeminal nerve and upper cervical roots. In migraine with aura, paroxysmal depolarization of neurons in the cerebral cortex is involved in the mechanism of development of HA. In the first phase of an attack in the region of the occipital pole of the brain, a cortical depression spreading at a speed of 2 mm per minute is observed. 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 feature classic migraine - general hypovolemia in the back of the brain. HD is caused by the action of spreading depression on the trigeminal fibers on the meninges, with the release of vasoactive intestinal peptide, substance P and several other peptides. The factors triggering the mechanism of spreading cortical depression are quite numerous. Among them are any violations of potassium homeostasis, genetic predisposition, stress, nutritional factors, as well as the release of vasoactive peptides from the trigeminovascular system.

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

Migraines can be caused by prostaglandin E1, tyramine, or phenethylamine (the last two amines are found in chocolate and cheese).

Tension headache. It was previously thought 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 vessels by a spasmodic muscle with venous congestion, the spread of pain to the temporal, parotid and occipital regions due to dysfunction of the temporomandibular joint, violation of the closure of the teeth of the upper and lower jaws, etc.

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

Headache symptoms. In each case, the symptoms of a headache are determined by the type of cephalalgia present. Below are the features of various types of chronic and recurrent headache according to a number of indicators (character, localization, duration of an attack, frequency, concomitant symptoms). Simple migraine: the nature of GB is pulsating; localization - one- or two-sided; attack duration - 6-48 hours; frequency - sporadic attacks (up to several times a month); concomitant symptoms - nausea, vomiting, malaise, photophobia. Classical migraine: the nature of GB is pulsating; localization - one-sided; the duration of the attack is 3-12 hours; frequency - sporadic attacks (up to several times a month); concomitant symptoms - visual aura, nausea, vomiting, malaise, photophobia. Facial migraine: the nature of GB is dull or pulsating; localization - unilateral, in the lower half of the face; attack duration - 6-48 hours; frequency - sporadic seizures; accompanying symptoms - nausea, vomiting. Cluster headache (Histamine cephalgia of Horton): the nature of GB is acute, boring; localization - unilateral (mainly in the orbit); the duration of the attack is 15-20 minutes; periodicity - periods of daily attacks alternate with long-term remissions; concomitant symptoms - on the side of pain, lacrimation, flushing of the face, nasal congestion and Horner's symptom may be noted. Psychogenic headache: the nature of GB is dull, squeezing; localization - diffuse bilateral; the duration of the attack is often constant; frequency is often constant; associated 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; concomitant symptoms - trigger zones are identified. Atypical facial pain: the nature of GB is dull, localization is unilateral or bilateral, the duration of the attack is often constant; frequency is often constant; associated symptoms are depression, sometimes psychosis. Headache with sinusitis: the nature of headache is dull or acute; localization - one- or two-sided, in the area paranasal sinus; the duration of the attack varies; periodicity - sporadic or constant; accompanying symptoms - discharge from the nose.

Diagnostics. A specific diagnosis in children is established mainly on the basis of clinical signs and the above criteria for cephalgic syndromes. Help in the diagnosis can be provided by the 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). Important diagnostic measure consultation of an ophthalmologist is required, and if a patient is suspected of having depression, a consultation of a child psychiatrist is required.

The diagnosis of "migraine" is usually established on the basis of the collected anamnesis, while any pronounced changes cannot be detected during careful physical, neurological and ophthalmological examinations. Diagnosis of most other cephalgic syndromes is carried out using a similar algorithm.

Headache Treatment Approaches

Not all drugs used in the treatment of GB in adults can be used in pediatric practice due to age restrictions. A classic example is analgin (metamisole sodium), which in world practice is not prescribed for 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 the three main cephalgic syndromes - migraine, cluster headache and tension headache.

Migraine treatment. Prophylactic treatment is carried out only for recurrent cephalalgia, resistant to the emergency treatment used. Migraine attacks should be treated only when it comes to frequently recurring severe attacks that interfere with active life child . In some cases, one has to rely on only a partial effect, although the appointment of vasoconstrictors such as ergotamine and / or caffeine at the first symptoms of an attack can help to stop it (in the Russian Federation, the drug caffetamine, which combines both of the above components, is widely used). It is prescribed to children over 10 years old 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 appointment of simple (non-narcotic) analgesics (paracetamol, etc.) is often no less effective.

In an acute migraine attack, regimen moments should be combined with taking 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 old - only for vital indications) 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 and severe severity. Acetylsalicylic acid is effective only for mild attacks. Other medicines to treat severe seizures are naproxen, ibuprofen, phenacetin, or caffeine (alone or in combination with other medicines).

For children older than 10 years, ergotamine is considered the drug of choice. It is administered orally at the very beginning of an attack (the dose depends on the drug used). dosage form, the duration of the course of treatment should not exceed 7 days). The drug is contraindicated in children who have hemianopsia or hemiparesis in the constrictor phase of the 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 under 1 year - 0.025-0.05 g each, up to 2 years - 0.1 g per reception). 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 part of combined funds(asphena, cofitsil, novogrofen, 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 for children under 5 years of age at the rate of 2.5-5 mg / kg / day in 1-3 doses (the duration of the treatment course is up to 14 days), and for patients older than 5 years of age - at a dose of 10 mg/kg/day.

Caffeine is a psychomotor stimulant used in combination with other drugs (analgesics, etc.). For children older than 2 years (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 a part of combined tablets (cofetamine, askofen, novogrofen, cofitsil, pyramein, citramon, etc.).

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

Preventive treatment. Propranolol is administered orally to children at an initial dose of 0.5-1.0 mg/kg/day 2 times a day, the maintenance dose is 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 at a dose of 5 mg 1 time per day. The rest of the categories of children are prescribed flunarizine in the same way as adults (20 mg 1 time in the first 2 weeks of prophylactic treatment, then 5-10 mg / day in 1-2 doses).

Anticonvulsants of the phenobarbital or valproic acid class in some cases can 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 migraine (more often these drugs are used for tension headache).

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 rapid effect, you can use up to 3 age doses of the drug (intravenously) every 15 minutes. At parenteral administration in children older than a year, a single dose is 250-500 mcg / kg (the maximum dose in children under the age of 5 years 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 of 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 old - 75 mg per day.

Non-drug treatments for migraine

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

Among other non-drug approaches to the preventive treatment of migraine, wushu, karate, yoga, biofeedback training, and acupuncture should be mentioned.

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

Preventive treatment of cluster headache involves the appointment of β-blockers (propranolol, etc.), carbamazepine, lithium preparations, as well as prednisone (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). Medium daily dose the drug (orally) is 20 mg / kg / day (on average, in children up to a 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 old - 0.6-1.0 g / day).

Of the lithium preparations, lithium carbonate (kontemnol, sedalit) is more often used. This normothymic remedy is taken with food, washed down with water or milk. At the same time, the content of lithium in the blood is controlled, maintaining its concentration of 0.5-1.0 mmol/l. At a dose of lithium carbonate of 1.0 g/day, normalization of the lithium concentration should be expected in 10-14 days. The course of prophylactic 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 canceled.

Verapamil (isoptin, phenoptin) is a calcium channel blocker. It is taken orally during or immediately after meals (in 2-3 doses). The drug is washed down 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).

Tension headache treatment. 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.

Tizanidin (sirdalud) - a muscle relaxant central action widely used in the treatment of tension headache 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) for children is prescribed starting from 0.01 g 1 time per day, gradually (within 10 days) the dose is increased to 0.02 g for children 1-7 years old, up 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).

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