Migraine Headaches

Migraine headaches have made the news recently.  Migraines are a specific type of so called “vascular “headache.  This is because migraines occur when arteries around (not IN) the brain first becoming constricted and then becoming grossly dilated.  This is what causes the terrible pounding sensation.  Typically the pounding pain occurs on one side of the head (“heMICRANIUM”–half the head–source of the word “migraine”).  The pain usually resolves after a few hours but can rarely last for days.

Other symptoms associated with migraines:

• nausea and vomiting
• dizziness
• neck pain
• light hurting eyes (“photophobia”)

Migraines do not cause cause fever, rashes, or cough/respiratory symptoms (although they may rarely result from sinus infection).  Frequently recurring episodes, confusion, severe lethargy, or sleepiness are very rare.  If your child has these symptoms associated with migraines you should have this investigated.

A scientifically interesting, if emotionally disturbing, pre-symptom of migraine is the  prodrome “aura.” During the early artery constriction phase of the process people may often experience strange sensations like seeing flashing lights or zig zag lines, smelling strange odors, or sometimes very odd behavior phenomena.  

There are many things we can do to treat or prevent migraines:

1. Limit stress wherever possible–don’t over schedule your child’s life
2. Adequate rest–adolescents need >8 hours of sleep.  Naps are helpful but do not replace a full night’s sleep
3. Regular meals–especially breakfast
4.  Limit eye strain–get those cell phones, tablets, computers, video games out of the child’s bedroom
5. Use the “prodrome”–analgesics like acetaminophen or ibuprofen can be very effective if administered early on.  The severe migraine can often be prevented by identifying “prodromal” symptoms, taking above medicines, and resting in a dark, quiet room with a cool compress on the child’s head for 20-30′.
6. Anti-nausea medicines like promethazine (“phenergen”) or ondansetron (“zofran”) can ease those symptoms
7. For frequent or severe migraines (>weekly occurrences) we frequently employ a number of daily “maintenance” medications.  However, recent studies raises serious doubts about the efficacy of this approach, so we should consider these medications carefully in light of this new evidence.

Please contact me with questions about headache and migraines in your child; and thanks for following.

 

Don’t use homeopathic teething gels and tablets

A few words about infant teething.  The first “deciduous” teeth usually erupt anywhere from 6 months-2 years, but there is a lot of variability.  So called “natal teeth”–present at birth–occur in anywhere from 1:700-30,000 live births.

Reported symptoms associated with teething are fever (<101), fussiness, drooling, and mouthing objects.  Note that I called these “reported symptoms.”  That’s because none of these observations or behaviors are at all specific for teething. Firstly, to be honest, nobody has ever given me any reasonable explanation for how the eruption of a tooth through a child’s gums would raise that person’s body temperature.  So I have never paid much attention to fever as any evidence of “teething.” Fussiness?  I mean–I know this is a thing, but what is it?  How does one quantify it? Moreover, an observation of “fussiness” can be as much an indication of the parents’ state as the child’s: more tired, stressed parent=more “fussy” child. So often another dead end, as far as I’m concerned.  As for drooling and mouthing things–these are normal behaviors of children at this stage of life generally, whether teething or not.  So that tells us very little.

Anyway, if you think your child may be teething, what should you do?  Given what an otherwise mild, natural process this is, I don’t want you to do too much.  First of all, brush your baby’s erupting teeth.  Latest guidelines from pediatric dentists is that the indication to brush is the presence of the child’s tooth.  You can give acetaminophen or (after 6 months old) ibuprofen.  Frozen teething rings or certain food objects can be gummed for relief( I like frozen pizza crusts, bagels, or heel of Italian bread).  A q-tip dipped in warmed whiskey or brandy can be applied to the erupting tooth for some relief.  Most importantly, read or play with your child–an entertained baby is a calmer baby.

What about homeopathic teething tablets or gels?  NO.  This is the most important take home point of this blog entry.  The Food and Drug Administration (FDA) is urging  consumers to stop using these products and dispose of any in their possession.  There are substantial reports that these things are associated with seizures in children who use them.  Other symptoms that have been noted in children using homeopathic teething gels and tablets include breathing difficulty, sleepiness, lethargy, muscle weakness, skin flushing, and constipation.  If you believe your child may have experienced any of these problems in association with use of homeopathic teething gels or tablets, you can report your concern to the FDA at 1-800-FDA-1088.

Please contact me with any questions, and thanks for following.