By A . David Rothner , MD

recurrent abdominal pain caused by many primary G . I . diseases , may contribute to the occurrence of tension-type headache .

What about food and migraine ? The differences between food allergies and dietary triggers should be discussed . There is no question that chemical additives contained in food are vasoactive and , among other mechanisms , can cause true episodic migraine . These reactions are not immune mediated . There are discussions , disagreement , and some research regarding which food and what quantities have a role in migraine and possibly in tension-type headache .

Management In a youngster seeking consultation for significant refractory headache ( migraine or C . D . H .), I routinely address : A . Patient / parent education ( written materials ) B . Confident reassurance that underlying problems have been excluded C . Stress reduction D . Adequate sleep

H .

Adequate exercise

I routinely exclude foods that the patient or parents feel play a role , plus : caffeine chocolate lunch meats aged cheese monosodium glutamate ( MSG ). I ask for complete cooperation for 6 to 8 weeks and then consider reintroducing food in moderation . Lists of other provocative foods are easily found .

Summary Research into allergies , diagnosed by a thorough history , skin and blood tests , or elimination diets has not definitively shown that they cause headache . In all cases , consult your physician or obtain a second opinion before embarking on an arduous expensive course of therapy . HW

A . David Rothner , MD , Pediatric Neurology Cleveland Clinic Foundation , Cleveland , Ohio

26 HEAD WISE | Volume 3 , Issue 1 • 2013