Center for rare Pain Syndroms

Das Auftreten von Kopfschmerzen bei Kindern und Jugendlichen hat sich in den letzten 10 Jahren nahezu verdoppelt.

Durch Kopfschmerzen gehen 1 Millionen Schultage verloren.
Zumeist handelt es sich um einen primären Kopfschmerz, also ein Schmerz ohne andere organische Ursache.

Sicher ausgeschlossen werden muss eine schlimme Ursache für die Kopfschmerzen. Wenn man das Vorkommen eines Hirntumors auf alle Altersklassen bis zum 16. Lebensjahr aufsummiert so ergibt sich ein Häufigkeit von 0,4 Promille, es kommt also extrem selten vor .

Am häufigsten sind Spannungskopfschmerz gefolgt von Migräne.

sekundary HA

In the beginning it is important to check if a severe disease may be the causing agent of the headache.

Hints for this might be:
-Acute beginning
-Vomiting in the morning
-Stiff neck
-Neurologic loss
-Cramps
-Age < 3 years

We will directly organize a magnetic resonance imaging and a neurologic or neurosurgical examination. Another causing agent for headache can be an infection or middle ear inflammation

	Spannungskopfschmerz	Migräne
Häufigkeit	58 %	8 %
Dauer	1/2h - 3d	4 - 72h
Lokalisation	beidseits, drückend	einseitig, pochend
Aktivität	gleichbleibend	Verschlimmerung
		Besserung durch Schlaf
	Meiden von Licht ODER Geräuschen	Meiden von Licht UND Geräuschen
	keine Übelkeit	Übelkeit

primary HA

In most of the cases the origin of headache is not a severe organic disease. In any case the anamnesis is one of the most important facts when finding the correct treatment.

When, where and how often does the children experiences headache?

What increases or decreases the intensity?

Is there anything which triggers the pain?

How is the familiar environment, the relation to parents, siblings or to classmates?

The most often diagnosis is either tension headache or migraine.

Typical acute triggers for headache can be fever, infections or a middle ear inflammation. Only in rare cases the headache is caused by a more severe disease.

The primary headache accounts for most of the cases where the pain itself can be seen as the disease.

Divorcement of parents	5,8
alcohol consumption	3,4
smoking	1,5 - 2,7
Coffee	2,4
less movement	1,2 - 2,2
no freetime	m:2,1 w:1,0
Music >2h/d	2,1
Dissatisfaction	1,9
Mobbing	1,2 - 1,9
mistreatment	1,6
Obesity	je 1,4

In der Tabelle sind typische Auslöser aufgeführt. Die Zahlen sind die sog. Odd`s Ratio und sagt aus, um welchen Faktor Kopfschmerzen häufiger Auftreten.

If the headache is caused by any kind of organic disease it is of course more important to treat this in the first place.

The primary headache applies for most of the cases and the search for the triggering agent is most important. Our experience has showed that simple things like relaxing, sports, freetime or drinking more water contributes to the recovery.

It is also possible to change the diet for some weeks where the patient should avoid cow milk, sweets and lemonade, chocolate, wheat flour, eggs, cheese, tomatoes, fish, soy or pig meat.

In addition to this we can offer a TENS therapy, give a bio- feedback, acupuncture or homeopathics.

During childhood there are special guidelines for medications.

Paracetamol is licensed for infants but the dosage needs to be measured exactly.

Ibuprofen is licensed for children which are older than 6 years.

Metamizol can be taken from the 3. Month

Sumatriptan is only licensed for children which are older than 12 years.

Even if most of this drugs are on the free market it is always better to consultate your doctor in advance.

Childrens HA

sekundary HA

primary HA