The diagnosis and management of headaches in childhood

Chronic headaches are relatively common in children and adolescents. The majority of these are benign and do not reflect organic pathology. Diagnosis can usually be made by careful history and physical examination, and extensive laboratory investigations are rarely required. Most children can be managed with reassurance, simple analgesics, and mild sedation. For more severe cases, particularly of migraine, effective pharmacologic agents are available. The prognosis is favorable. Very few of these children go on to develop significant intracranial pathology, and the majority will remit spontaneously. A significant number, however, do have chronic headaches in adult life.