kids ’ korner
By A . David Rothner , MD
A L L E R G Y A N D H E A D A C H E Fact & Fiction
A common question at the conclusion of a pediatric headache consultation is :
Are my child ’ s allergies causing the headache ? The answer to the question is multifaceted . It could involve a discussion of seasonal allergies , sinus issues , food allergies , gluten and celiac disease , and the effect that chemical additives in food can have on the body .
Allergies of all kinds , abdominal pain , sinus symptoms , and headaches are among the most common maladies that children and teens experience . The high frequency of these various disorders contributes to the misconception that they are related . It is , therefore , entirely reasonable that patients experience more than one of these conditions and mistakenly conclude that one ( allergy ) causes the other ( headache ). Let ’ s examine the facts .
Definition Prior to proceeding with this discussion , it is important to define Migraine and Tension-Type Headache ( T . T . H .). Neither of these conditions have been proven to be caused by allergies .
Episodic migraine in children and adolescents , in over 80 percent of cases , is genetic in origin . If a mother experiences episodic migraine , each of her children stands a 50 percent chance of having migraine . The usual childhood migraine is not daily and occurs 2 to 8 times per month . The patients often become quiet , appear pale , have dark circles under the eyes , become listless or irritable , and develop a strong pounding headache . The child may want to lie down , stop activity , and become sensitive to light and noise . Most lose their appetite and refuse food . Many children experience relief after sleep . The entire episode may last 1 to 4 hours . Both analgesics and triptans may be needed .
The cause of T . T . H . is less clear . Stress , heredity , environment , and G . O . K . ( God only knows ) have all been implicated . In most instances , it is occasional , occurring once or so per week , but it may become more frequent . If it occurs less than 15 days per month , it is called Episodic T . T . H . If it occurs more than 15 days per month , for months on end , it may be called Chronic Daily Headache ( C . D . H .). In many patients with C . D . H ., occasional episodic migraine is also seen . In patients with T . T . H , pallor and dark circles are less prominent , and personality changes are less marked . The headaches are less pounding and severe , the patients are less sensitive to light and noise , and do not lose their appetite , develop nausea , or vomit . Simple analgesics are often effective .
24 HEAD WISE | Volume 3 , Issue 1 • 2013