My Daughter Is 9, Turning 10 Years Old. She Was

Posted on Fri, 3 Jan 2020

Question: My daughter is 9, turning 10 years old. She was a figure skating athlete with an active life. But 6 weeks ago she got up complaining of headache and it has been constant since then. She has tried Tylenol and Advil, separate or combined, but neither way helps. She didn't fall hitting her head and didn't think she had any hard fall jerking her neck/head either. She has been very normal prior to the first day of headache. The first week she was afraid of loud noise but problem disappeared after. The headache has somewhat got a bit worse. The worse time of the day is right after she got up. She did MRI last week and result is negative. No issue. She has no other symptoms except recently she can not focus on math and writing and she felt she knew how to do it but her mind was blank at the moment. She has stopped all sports since first day of her headache. She also slept much longer during the night, now for about 13hrs a day. In the past, it was about 9-10hrs/day. She tried a migraine medication today but no impact. it was called Sumatriptan SUCC 5mg. She doesn't have family history of migraine. She has been doing acupuncture but relieve was only for 2-3 hours and then headache would come back. She has a normal family life and generally a very happy girl and not easily stressed. Wonder if you have any suggestions?

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
Prophylaxis treatment should be considered.

Detailed Answer:
Hello again.

I have read your query and here is my advice.

Since MRI of the brain resulted normal and excluded any organic causes of headaches, there is no need to be worried about anything serious.

I still think that migraine should be the most likely condition that is causing your daughter's issues.

Since the headaches are constant and not occasional such as in most types of migraine, continuous treatment ( prophylaxis for migraine ) should be considered.

Triptans are drugs used mainly in the acute phase of migraines.

Possible medications to be used in a daily basis include antidepressants (amytriptiline ), propranolol, anticonvulsants ( valproate, topiramate ), etc.

Discuss with your daughter's Doctor for the possibility of prophylaxis treatment of these headaches.

Hope you found the answer helpful.

Feel free to ask if you have further questions.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Erion Spaho (3 hours later)

Thank you Dr. Spaho! Now that we have MRI result, she is being referred to a paediatric neurologist but it may take 2-3 months to get an appointment given her consideration is not urgent. so we are trying to find a US doctor sooner. Based on what you suggested, having a neurologist with prophylaxis treatment for migraine is perhaps the next route.

one more question - when she gets up from the bed in the morning, she immediately feels pain and has to really slow down. during the day, when changing position from laying to standing, she also feels more headache but not as strong as the morning. Is this typical of migraine?

Thanks again!
Helen

Answered by Dr. Dr. Erion Spaho (6 hours later)

Brief Answer:
Some other considerations to be noted.

Detailed Answer:
Welcome back.

Thanks for the additional information.

Migraine remains the most likely cause to be treated.

However, since there is a relationship between headaches and body position, some other conditions should be still considered and evaluated further.

Changes in blood pressure may cause headaches.

These possible changes in blood pressure linked to body position, on the other hand, may indicate cardiac problems such as arrhythmias, etc.

So, evaluation of cardiac function is necessary too.

Migraine headaches are not typically linked with different body positions, and, besides the changes in blood pressure, changes of intracranial pressure also should be also considered, but this is very unlikely with a normal brain MRI.

So, I suggest you discuss these other possibilities with the Doctor when you see him.

Hope I helped you.

Hope to hear good things from you soon.

Above answer was peer-reviewed by : Dr. Arnab Banerjee