Headaches in Children

The article on headaches in children in the June/July issue of Neurology Now was interesting but you failed to mention allergies as a cause of headache. In 2004, my then 12-year-old son had chronic headaches. After multiple doctors' visits and a trip to a leading pediatric headache clinic, it was recommended that he be started on daily medication for early-onset migraines.

Luckily, a friend suggested that I have him tested for allergies, as she had gotten relief from recurring migraines after beginning allergy treatment. We discovered that my son was allergic to nearly everything on the test panel—all trees, grasses, weeds, pollens, indoor pollutants, feathers and animal dander, tobacco, and a few food items. We also discovered that he had allergy-induced asthma. Shortly after he started injections, the headaches all but disappeared. As the allergist told me, not all headaches are caused by allergies, but allergies can and do cause headaches. - Renee C. Devine, Drexel Hill, PA

I was disappointed that in your recent story on headaches in children, there was no mention of the role of physical therapists in the evaluation and treatment of their symptoms.

Far too often, children have poor postural habits that can cause or exacerbate headache. For example, sleeping on too many pillows, studying while sitting on a bed and looking down at a book or laptop computer, carrying a heavy backpack slung over a shoulder, sitting with a slouched posture in school for long periods, playing video games while sitting or lying on the floor—all of these things can make headache worse.

In my practice, I have found that altering these behaviors may decrease and in some cases eliminate headaches. This is in contrast to the experience of many of the children who, prior to receiving a physical therapy evaluation and treatment, had seen several specialists and been prescribed numerous medications without significant positive benefit. - Debbie Goldstein, P.T., Columbia, MD

In my experience as a physician's assistant, another possible reason for migraine-like headaches in adolescents is postural orthostatic tachycardia syndrome (POTS). These patients can experience a number of different symptoms related to low blood volume, which results from a dysfunction of the autonomic nervous system. POTS often presents itself following a viral illness such as mononucleosis. Many of these adolescents respond quite well to conservative therapy such as increased hydration and elimination of caffeine. Many of them also outgrow the syndrome as they enter their late teens and early twenties. - Faith Pescatore, PA, Novelty, OH

THE EDITOR RESPONDS: Thank you to Renee, Debbie, and Faith for pointing out some of the other causes of headache in children and adolescents that might be easily overlooked. Read more articles about headache.

Fibromyalgia

I read your magazine in my neurologist's office and am now a subscriber. Thank you for the articles on fibromyalgia, which I have. They encourage me to adopt healthy habits in my daily life. In addition, after reading the letters to the editor on the importance of becoming an organ donor, I am considering becoming a donor myself. - Leo Shatin, Boca Raton, FL

Jack Osbourne: Getting Real About Multiple Sclerosis

In an odd way, I'm glad that such an outspoken family has the opportunity to share this. The monster that this disease can be was once, seemingly long ago, taken on by Montel Williams and a few others who had the voice to say something and be heard, but somehow they've taken a back seat and been far less vocal. Sorry you're joining the ranks, Jack, but glad you're with us.  - Mija Sipuedo, from Facebook