Headache in Kids in afya

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50% 7yr, 80% 15yr have had a headache
M=F till puberty then F:M 3:1
Most common cause of headache in kids is migraine

''Migraine without aura Criteria''
 >5 attacks fulfilling ....
lasting 4-72 hours
2 of these features - bilat or unilat (frontal or temporal), pulsating, moderate to severe, aggravated by routine activity
1 of these features - nausea or vomiting, photo or phonophobia

Acute Mx
Brufen better than Paracetamol
Triptans - only start by specialist
Sumatriptan nasal spray is only licensed med but not liked by kids as nasty taste
Zolmitriptan orodispersible is unlicensed but widely used over 8yrs
SE - tingling, heat and heaviness sensations

Prophylaxis
no clear consensus
?Pizotifen and propranolol 1st line, valproate, topiramate and amitryptiline 2nd line

''Tension type headache''
second most common cause headache in kids
//Diagnostic criteria//
 >10 headaches fulfilling ...
lasts 30mins - 7/7
at least two of ... 
pressing / tightening (not pulsating), 
mild to moderate (inhibit but not prohibit activity)
bilateral
no aggravation by routine activity
Plus both of no nausea / vomiting but photo/phono phobia is present

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