Therapy Of Headaches In Children And Adolescents

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Therapy Of Headaches In Children And Adolescents
Therapy Of Headaches In Children And Adolescents

Video: Therapy Of Headaches In Children And Adolescents

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Video: Migraines and Headaches in Children – Pediatrics | Lecturio 2023, January

Headache in children: therapy

The therapy is based on the symptoms and the general conditions (place of residence, family situation, duration of lessons). It assumes the willingness to actively participate in the treatment and to follow the therapy plan (compliance). Depending on the course, the therapy is continuously adjusted.

If headaches occur as part of an underlying illness (e.g. flu), this is treated accordingly and a child-friendly painkiller is administered. Tension headaches and migraines require therapy measures specifically tailored to these types of pain.

If pain medication is used more than ten days a month for a period of more than three months, an additional medication-related headache occurs. Chronic headaches should be treated by headache specialists.


  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • Migraine Therapy
  • Tension headache therapy
  • Whom can I ask?
  • How are the costs going to be covered?

Note Doctors and pharmacists provide information about side effects and interactions between drugs. Under no circumstances should headache medication be given to children without consulting a doctor!

Migraine Therapy

Children of preschool age or early school age often help to retreat to a darkened, quiet, well-tempered and well-ventilated room. If the nausea allows it, a glass of water should be drunk. The children should lie down and sleep if possible. If experience has shown that severe headaches last longer than two hours, drug treatment is advisable. Pain medication should be taken as early as possible when the approaching attack is detected and in a sufficiently high dose. It should be noted that a certain agent should be used in at least six attacks. The following active ingredients are mainly used:

  • Means used to relieve pain and lower fever in children and adolescents: mefenamic acid, paracetamol, ibuprofen.
  • Zolmtriptan nasal spray, a special migraine drug from the triptan group, is approved in Austria for adolescents from the age of twelve for the treatment of migraine attacks if the above-mentioned active ingredients do not provide satisfactory relief.
  • Drugs that are available as syrups should be preferred especially in children. Half of the syrup in the prescribed dose should be briefly sucked into the oral cavity so that the active substance is absorbed for the first time.

Prevent migraine attacks

The first step in preventing migraine attacks is to consider some lifestyle aspects:

  • A relaxed start to the day (approx. 40 minutes between getting up and leaving the apartment)

  • Drink enough
  • Regular meals
  • Healthy sleep rhythm
  • Breaks while studying
  • Exercise (especially endurance sports)
  • Avoid regular consumption of beverages containing caffeine
  • Stress management (eg: "Do you have enough free time to play?" "Has the school been chosen correctly?")
  • No visual electronic media (e.g. cell phone, television) 30 minutes before bed

If lifestyle adjustments do not lead to any improvement, biofeedback is a way of reducing the frequency of migraine attacks. The peculiarity of primary headaches in childhood and adolescence is that the frequency of headaches can be reduced significantly (e.g. from several times a week to less than once a month). To do this, it is necessary to observe rules for everyday life and specifically treat those problems that can exacerbate headaches (for example, learning difficulties due to partial performance weakness). Frequent migraine attacks can also indicate another problem that is impairing wellbeing.

If drug prophylaxis is absolutely necessary, flunarizine is the substance of first choice. However, for no more than three to six months and only once in a lifetime, because of a blockage of the so-called dopamine D2 receptors. Preventive uses of beta blockers and topiramate found in the literature should be avoided insofar as there are no long-term studies on sequelae in adulthood.

If girls have frequent migraine attacks before or during menstruation, the active ingredient naproxen can be used for a few days as short-term prophylaxis with the consent of the parents. Hormonal therapy should be avoided in this age group.

Tension headache therapy

It is often helpful to avoid known triggers or to change the triggering situations (e.g. school problems, difficult family situation). However, this can prove to be a challenge. Painkillers like those used for migraines should be used very cautiously for tension headaches.

In school age, a regular wake-sleep rhythm and more outdoor exercise or relaxation methods usually help. In the case of emotional stress, clinical-psychological advice or Treatment or psychotherapy effective.

Whom can I ask?

The first point of contact for headaches in childhood and adolescence is the pediatrician. He / she then initiates further steps as required. There are also specialized headache clinics. Chronic headache should be treated by a headache specialist. To find out when you should definitely consult a doctor, see Headaches in Childhood: Causes & Diagnosis.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are usually taken over by the health insurance carriers. In the case of certain services (e.g. inpatient stays, medical aids, etc.) - depending on the health insurance provider - patient co-payments are provided. Basically, your doctor or the outpatient clinic will settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (e.g. BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

For certain non-drug treatments - in some cases only when a certain level has been reached - approval from the health insurance provider may be required. For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

When making use of psychotherapy, full cost coverage is possible in the health insurance institutions' own or contractually bound institutions, as well as in institutions that are subsidized by the public sector. In these cases, however, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are undergoing psychotherapy with a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist. However, the health insurance carriers only provide a subsidy if there is a so-called disease-related disorder.You can find out more about reimbursement on the social security website.

The clinical-psychological diagnosis is a service provided by the social health insurance, the costs of which are borne by the health insurance carriers. You must bear the costs for treatment or advice from resident clinical psychologists yourself, as this is not a benefit from health insurance.

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