Headache

• Red flags in childhood headaches:

  > change in pattern (e.g. ‘worst headache ever’),

  > progressive course over time,

  > age younger than 3 years,

  > nocturnal/wakes child from sleep,

  > early morning vomiting,

  > ataxia,

  > focal neurological signs,

  > alteration of level of consciousness.
• Paediatric migraine is more common in girls
• The most common type of paediatric migraine is the migraine without aura
• Migrainous headaches are usually unilateral but can be bilateral
• If pain persists despite analgesia, referral to paediatrician may be required
• Treatment is symptomatic with paracetamol or ibuprofen as first line
• Migraines are often associated with nausea or vomiting