AAN 2025 | Treating and diagnosing pediatric headache: advice for clinicians
Muhammad Yousaf, MD, Virginia Tech Carilion School of Medicine, Roanoke, VA, comments on the challenges of managing pediatric headache and gives advice to clinicians. He explains that the same treatment approach should be taken as adults, and highlights the need to adapt assessment methods so they are suitable for children, by incorporating tools like headache drawings. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.
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Transcript
Pediatric headache is a challenge, I mean no doubt about it, but the fact that these patients and this population should be treated the same way as adults is very important, which means that we might not have that repertoire of medications, especially with the evidence coming along, it is helpful. But at the same time, we have to remember that the patients might not have those words to describe their symptomatology and that’s why we have to give them those right words and we can help them out...
Pediatric headache is a challenge, I mean no doubt about it, but the fact that these patients and this population should be treated the same way as adults is very important, which means that we might not have that repertoire of medications, especially with the evidence coming along, it is helpful. But at the same time, we have to remember that the patients might not have those words to describe their symptomatology and that’s why we have to give them those right words and we can help them out. For instance, migraine is very underdiagnosed in pediatric patients as it is in adults. So for photophobia or phonophobia, ask them different questions, move around them. For instance, would you go outside in sunlight? Would you wear glasses? For phonophobia, would you turn the television down if you have a headache? Would you go to a birthday party? So different small tips can really help to know better and make a better diagnosis. That’s one. The other thing is that we have to remember pediatric headache leads to significant charge on the quality of life. There was a study done in 2003 by Dr Powers which showed that quality of life with patients with pediatric headache might be similar to what they have in chronic illnesses like rheumatoid arthritis or cancer. So we have to remember these facts while we are treating them. And also, it’s the third leading cause of school absenteeism. It’s also one of the major causes of peer relation problems. Also, same at the domestic levels. And these kids can, in future, have a higher chance of having mental health challenges. So to optimize the acute and preventive plan is super important. Give them the words. And one tip is to make them draw headache drawings. That’s really helpful in my practice. That’s how I can do better with them because they can give me clues like if they have photophobia, phonophobia, what kind of quality of headache they’re experiencing. And that has really helped over the years as well.
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