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Baby Medical Q&A, Issue #075 - Headache
December 01, 2012

Welcome to another edition of Baby Medical Q&A News.

Happy Holiday Season everyone.

This month's topic is headahce in toddlers and young children. A couple of recent questions illustrate the problems parents face and I hope you find the answers and links to new information useful.

Question: First, thank you. Yours is the first site I've found ANY relevent information regarding toddlers and headaches. Second, we are scheduled to have my son seen by his pediatrician, but I want to go with more knowledge in hand. I believe my 19 month old son to be suffering from debilitating headaches or migraines, and there is VERY little information about why it's happening or how to treat this in a very young child. I would be interested in any more info you have on this topic or if you can direct me to something more specialized so I know what questions to ask our own doctor. Thanks, again.

Answer: It is important your toddler has a full medical examination, particularly looking for signs of raised pressure in the skull (raised intracranial pressure).

I have a low threshold for scanning in young children with headaches but you have to weigh this up with the risk of scans. CT scans have relatively high radiation so you don't want to do them unnecessarily but they can be useful so any risk has to be weighed up against potential benefit. MRI scans donot carry the radiation risk but often require a general anesthetic in young children who may not be able to lie still enough and anesthetics have a risk associated with them. The risks of both scans on a one-off basis are actually low, but nevertheless must be considered.

At the end of the day, your doctor needs to take a full history of what you believe are the headaches, examine fully the neurological system and then decide if scanning is likely to be more beneficial than any risk.

You can read more on the risks related to imaging of the brain by clicking here.

Question: Should I get my child's eyes tested if she has headache?

Answer:If you are concerned your child can't see well or if you notice any issues with the eyes such as squints, then get an eye-test. However, if it is just headaches your child is suffering from, then a study has shown that simple visual problems are unlikely to be causing headaches in children and so correcting visual disturbance with glasses is unlikely to help headache.

Reference:Roth, Drack, Rychwalski. Headaches in Children Appear Unrelated to Vision Problems. American Academy of Ophthalmology (AAO) and Asia-Pacific Academy of Opthalmology 2012 Joint Meeting. Abstract #PO461. Presented November 12, 2012.

Finally, for an overview of how to recognise headache in toddlers and what the possible causes may be, read more on the updated "Does my toddler have headache?" page.

I wish you a headache-free festive season

Please feel free to share this ezine with family and friends.

Till next time,

Dr Maud

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