Testing & diagnosis for headaches in children

If your child is having headaches, one of the first things you’ll want to do is to get a solid understanding of her symptoms. Recording her headaches in a headache diary can help you see exactly how often they’re happening, understand your child’s symptoms better and notice possible causes or “triggers.” A record like this is also a good way for you to share information with your child’s health care providers.

In order to diagnose your child’s type of headaches, find the cause and recommend treatment, your child’s doctor will review her medical history, talk with you and your child about the symptoms and perform a physical and neurological exam. Questions that your doctor may ask include:

  • When do the headaches happen?
  • Where exactly does it hurt?
  • What do the headaches feel like, and how long do they last?
  • How are the headaches impacting your child’s life?
  • Is she having balance problems?
  • Does your child have other symptoms when she gets a headache, such as sensitivity to light or noise, nausea, dizziness or changes in vision?
  • What have you already done to try to relieve the headaches? How has it worked?
  • If you used medication, how much did you give your child? How long after a headache started did she take the medication?
  • Have you noticed anything that seems to cause her headaches?
  • Has your child been under a lot of stress or been having problems in school?
  • Has she been having other medical problems or been injured?
  • Has she been taking other medications unrelated to the headaches?
  • Have the headaches changed recently?
  • Has anyone else in your family had headaches? Has anyone in your family had other neurological problems?

If your child’s symptoms indicate that her headaches are “primary” headaches (migraine, tension or cluster headaches), and if her neurological exam is normal, no further diagnostic testing may be needed.

Our neurologists at Boston Children’s Hospital will obtain a detailed history and perform a careful exam to determine whether your child’s headaches could be caused by another medical problem. If needed, your child’s doctor may order diagnostic tests including:

  • blood tests
  • brain imaging scans

Our headache team will spend time talking with you and learning possible causes of your child’s headache pain. With your permission, we can also speak with your other health care providers or your child’s school to help us assess the situation.